When we swallow our food, it will be transported to the stomach via the oesophagus (a long tube that connects the throat to the stomach).
Our stomach contains acidic fluid which digests the food. While the human stomach is able to handle acidic stomach fluid, this is not the case for the oesophagus. There is a sphincter (rubber-band) located at the end of the oesophagus which prevents the backflow of stomach acidic fluid. It allows food to enter the stomach but not the other way round.
In a condition called gastro-oesophageal reflux disease (GERD), the sphincter is not functioning properly. Stomach acid flows back into the oesophagus and irritates its lining. This causes a burning sensation at the chest. Commonly described as heartburn or acid indigestion.
Constant irritation to the oesophagus can cause permanent damage over time. It causes the oesophagal to narrow, oesophagal ulcers or even cancers.
Although the commonest symptom is heartburn, some develop sour or bitter taste in the mouth. Others may complain of a chronic cough or dental caries.
These symptoms worsen when the one lies down or bends forward. On the hand, some find relief by standing upright or taking antacids.
Risks for GERD
Certain groups of individuals have a higher chance of developing GERD. The common risks include:
- Overweight or obesity
- Pregnancy
- Eating spicy and fatty foods
- Drinking alcohol, caffeinated or carbonated drink
- Smoking
- Taking certain medicines such as aspirin, ibuprofen, muscle relaxant etc.
Anti-Reflux Surgery
Most patients with GERD respond well with anti-reflux medication and lifestyle modification.
However, certain individuals will continue to have troublesome symptoms.
If left untreated, prolonged acid reflux will cause more sinister issues such as oesophagal ulcer, stricture or even oesophagal cancer.
Anti-reflux surgery is strongly indicated for such individuals to prevent the complications mentioned above.
Besides, anti-reflux surgery proves to be a welcomed solution for patients who cannot tolerate the side effects of the medication or be on long term medication.
Anti-reflux surgery involves creating an effective valve mechanism at the bottom of the oesophagus. It can be done via traditional open surgery or laparoscopic surgery.
Laparoscopic surgery has a few added benefits. It requires smaller incisions. In such, patients will experience less pain after surgery. Recovery time is shorter too. They are discharged earlier from the hospital and are able to return to their usual routine faster.
Dr Cha Kar Huei
MD (Canada) FACS (USA)
Consultant Bariatric and General Surgeon
Dr Cha is a surgeon at the Subang Jaya Medical Centre (SJMC). He graduated from Dalhousie University, Canada in 1998. He entered surgical training at Massachusetts General Hospital and completed his training at the University of Wisconsin in 2004.
He trained at the New York University Medical Centre on minimally invasive bariatric surgery and attained a Fellow of the American College of Surgeon in 2009.
Dr Cha is experienced in minimally invasive surgery with an interest in bariatric surgery. He is also a member of the American Society for Metabolic and Bariatric Surgery (ASMBS).
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