Statistics have shown that one in five Americans suffer from acid reflux. If you suffer from this health issue on a daily or weekly basis, it is a great time to seek help. Dr. Wiljon Beltre at the Center for Metabolic and Obesity Surgery in Maitland, Florida can answer your concerns and guide you to the best weight loss treatment option that will also alleviate your acid reflux symptoms.
What Is Acid Reflux and GERD?
Acid reflux occurs when stomach content is regurgitated into your esophagus and sometimes up to your throat. It is also commonly known as gastroesophageal reflux and acid regurgitation. If you experience acid reflux at least twice weekly, you may suffer from a health condition called gastroesophageal reflux disease (GERD).
What Are the Causes?
The most common cause is hiatal hernia. This happens when the upper stomach and the lower esophageal sphincter (LES) are pushed above the diaphragm. In its normal state, the diaphragm acts as a barrier to prevent stomach content from spilling back to the esophagus. But for individuals with hiatal hernia, the diaphragm fails to contain the fluid from returning to the throat.
Other Common Causes:
- Internal physical abnormalities
- Abnormally high stomach acid production
- Overweight and obesity
- Frequent large meals
- Always waiting too long to eat
- Eating close to bedtime
- Eating acidic foods such as tomato, chocolate, and citrus fruits
- Eating onions, garlic, and mint
- Eating spicy foods
- Eating fatty foods
- Eating fried foods
- Drinking alcohol, carbonated drinks, and caffeinated drinks
- Dramatic hormonal changes
- Taking certain medications such as aspirin, muscle relaxers, ibuprofen, and blood pressure medications
Heartburn is the number one most common symptom of GERD. It is characterized by a burning sensation that travels from your stomach up to your abdomen area to the back of your throat. Acid regurgitation can accompany heartburn. As a result of this reaction, you may feel a bitter-sour taste in the back of your throat or your mouth.
Other Common Symptoms:
- Frequent flatulence
- Constant burping
- Persistent hiccups
- Frequent feeling like something is lodged in the back of your throat
- Constant need to clear your throat
- Dry cough and/or wheezing
- Raspy voice
- Consistent sore throat-like symptoms
- Difficulty in deep-breathing
When to See a Doctor
If you experience heartburn, acid regurgitation, and other symptoms on a weekly basis, and over-the-counter antiacid medication cannot provide alleviation, it is time to visit your doctor. You may want to speak with your doctor even if you do not experience heartburn or acid regurgitation but show other listed symptoms. The occurrence of these lesser symptoms may mean that you are experiencing early stages of acid reflux disease.
To diagnosis the underlying physical issues that contribute to the reflux disease, your doctor may order one or more of these diagnosis tests:
- Barium swallow esophagram
- Esophageal manometry
Barium Swallow Esophagram
This x-ray method requires you to swallow a solution to help highlight internal structures on the scan. Through the scan, your doctor can detect any physical issues such as ulcers or esophageal abnormalities that may contribute to the problem.
For this test, a device is inserted into your esophagus to track the acidity level (pH level) fluctuation for a duration of one to two days. It can also check for malfunctioning of the esophageal muscles and the lower esophageal sphincter.
In this test, the doctor inserts a small camera down your throat to check for any physical abnormalities in your esophagus and/or stomach that may contribute to the health issue. During this process, anesthesia will be administered to your throat to alleviate any discomfort.
In a Biopsymay, tissue samples are taken from your esophagus and stomach to test for signs of infection and or any other abnormal growth. This procedure is often performed along with an endoscopy.
Depending on your diagnosis and the severity of the situation, the doctor may offer different treatment options. For less severe cases, over-the-counter antacid medication (such as Rolaids, TUM, Alka-Seltzer, Mylanta, and Maalox) along with lifestyle changes may already be sufficient treatment.
When antacids cannot produce any results, your physician may offer a prescription of these treatments:
- Foaming agent
- H2 blockers
- Proton pump inhibitors
These tablets create a barrier on top of your stomach content to prevent acid from flowing up the esophagus. Some brands such as Gaviscon pull double duty as antacid and pain reliever.
Also known as histamine H2-receptor antagonists, this class of medication helps reduce acid production in the stomach lining cells. The most common brands are Zantac, Pepcid, and Tagamet.
Proton Pump Inhibitors (PPI)
This class of medication reduces acid production by blocking stomach lining enzymes from functioning. It is prescribed for individuals who have ulcers and/or Zollinger-Ellison syndrome. The most common brands prescribed are Nexium, Prevacid, Aciex, and Prilosec.
When Should You Consider Surgery As a Treatment Option?
Medication and lifestyle changes sometimes are not sufficient to alleviate GERD. Here are some situations when surgery is considered:
- You have allergies towards particular medication
- The medication fails to relieve symptoms
- You suffer from pre-existing health conditions such as obesity and diabetes
- You have difficulty in taking medication
- You have an ulcer
- You suffer from hiatal hernia
- You have an abnormal lower esophageal sphincter
- You are at risk for severe complications from GERD
Types of Surgery to Consider
Depending on your diagnosis, your physician may recommend one of these surgery procedures:
- Sleeve Gastrectomy
- Gastric Bypass
- Gastric Band
- Biliopancreatic Diversion
This procedure is commonly recommended for obese patients who want to lose weight rapidly and suppress their appetite. During the surgery, the doctor removes the upper portion of the stomach (known as fundus) responsible for secreting an appetite-inducing hormone called ghelin. As a result, because the stomach becomes smaller and less ghelin is secreted to trigger eating tendencies, the patient tends to feel less hungry and becomes full much more quickly.
In addition, removal of the fundus also suppresses two other gastrointestinal hormones (incretins and peptide tyrosine-tyrosine) that are believed to cause GERD. For individuals who suffer from a reflux problem, this surgery can greatly alleviate symptoms.
Gastric bypass is an aggressive surgery aimed to help severely obese individuals lose weight and alleviate other health issues such as type-2 diabetes, cardiovascular disease, and GERD. After dramatically reducing the stomach size and shortening the small intestine, the patient will metabolize food much quicker. That means food will empty out of the stomach at a much quicker pace and minimize reflux frequencies. Research studies have shown that a vast majority of patients who have undergone gastric bypass confirmed overnight relief from GERD after their surgeries.
Please note that this surgery is the most invasive procedure amongst all options. But with new technology breakthroughs, gastric bypass can be done as a laparoscopic procedure with smaller incisions as opposed to the traditional open gastric bypass surgeries.
Gastric band is an excellent option for moderately obese individuals who are looking for a less invasive treatment that can help them lose weight and alleviate other health issues such as hypertension, cardiovascular diseases, arthritis, type 2 diabetes, sleep apnea, and GERD. Unlike other options, LAGB is a reversible and customizable throughout your weight-loss journey. There is no permanent reduction to your stomach or small intestines.
This laparoscopic surgery requires several small incisions to allow the insertion of a camera and other surgical equipment. A small passageway is created behind the stomach, and an adjustable silicone band is then fitted around to control the size of the opening. A portion of the band is then implanted under the abdomen skin. This allows your doctor to customize your band opening size to fit your diet goals without further surgery.
Biliopancreatic Diversion (BPD)
This is another intensive option to treat individuals who suffer from severe obesity and obesity-related health problems such as cardiovascular disease, type 2 diabetes, and GERD. In general, there are two types of Biliopancreatic diversion surgeries: Biliopancreatic diversion without duodenal switch (BPD), and Bibliopancreatic diversion with duodenal switch (BPD/DS).
Biliopancreatic Diversion Without Duodenal Switch (BPD)
This is regarded as a malabsorptive operation because it limits the body’s nutrient absorption function. In this operation, the lower two-thirds of the stomach, the pylorus valve, and the upper portion of the small intestine are removed to significantly reduce nutrient intake.
Biliopancreatic Diversion With Duodenal Switch (BPD/DS)
This is regarded as a fusion of both malabsorptive and restrictive operation because it reduces both food intake and the body’s energy abortion function. Unlike the traditional BPD procedure, the BPD/DS method includes removal of the left portion of the stomach, keeping the pylorus valve, and drastic shortening of the small intestine.
Surgery Recovery Duration
One of the biggest deciding factors for many GERD individuals is recovery time. Depending on whether the surgery requires incisions or not, the recovery duration may greatly differ. But in general, operations that are not open surgery tend to have a quicker recovery time.
Other Factors to Consider
If you are considering surgery as your treatment option, here are some other factors you may want to weigh in:
GERD Surgery Pros:
- Avoid long-term medication usage
- Prevent medication dependency and addiction
- Cut down on long-term medical bills
- Prevent further complications
- Improve quality of life
GERD Surgery Cons:
- Surgery can be expensive
- May require up to six weeks of recovery time
When dealing with GED, lifestyle and eating habits can further impact the long-term benefits of the surgery procedure. Many patients state that by making changes to their daily routine after their surgeries, they can eradicate all symptoms and no longer require any medications. Some of the most common modifications are:
- Limit consumption of fatty food
- Lower caffeine intake
- Quit smoking
- Eat smaller meals
- Eat more frequently
- Cut down on fried foods
- Take a stroll after eating
- Lower carbonated drink consumption
- Cut down on eating chocolate
- Reduce intake of stomach-stimulating foods
- Take in less acidic foods
- Avoid mint and certain spice
- Incorporate exercise into their daily routine
- Lose excess abdominal fat
- Learn ways to better handle stress and anxiety
- Lose weight
- Keep head slightly elevated during sleep
Without suffering from constant GED-related pain and discomfort, individuals can sleep better at night and focus their energies on their daily lives. It is an excellent improvement to the overall quality of life.
Start Living Your New Life Today
For more information about acid reflux treatments and weight loss surgery options, contact Dr. Wiljon Beltre at the Center for Metabolic and Obesity Surgery in Maitland, FL. We are here to answer any questions and concerns you have about weight-loss treatment options and help you decide if it could also help you achieve freedom from GED pain.