Anti-re­flux la­paro­scopic surgery

Costa Levante News - - HEALTH -

Med­i­cal Ad­vice from Quirón­Salud . When we eat, food goes from the mouth to the stom­ach through a tube called the oe­soph­a­gus, which has a small mus­cle ring on the lower end, act­ing as a valve; gas­tric re­flux oc­curs when the lower oe­sophageal sphinc­ter (LOS) does not work as it should, and al­lows acid to flow back and burn the lower part of the oe­soph­a­gus. ‘This ir­ri­tates and in­flames the oe­soph­a­gus, causes a sen­sa­tion of acid­ity, and in time may even dam­age the oe­soph­a­gus. It is of­ten ac-

Among its mul­ti­ple symp­toms, Doc­tor Blas Flor, Head of the Di­ges­tive Surgery Ser­vice and sur­gi­cal on­col­ogy spe­cial­ist at Hos­pi­tal Quirón­salud Va­len­cia, high­lights py­ro­sis or heart­burn, which is the sen­sa­tion of ret­roster­nal sting­ing or burn­ing; re­gur­gi­ta­tions, which are the re­flow of con­tent from the stom­ach to the mouth; and oth­ers, such as epi­gas­tric ab­dom­i­nal pain, tho­racic pain, apho­nia, cough with no ap­par­ent cause, and sleep prob­lems. This disease is be­nign and, in most pa­tients, has no com­pli­ca­tions, ‘though at times,’ warns the spe­cial­ist, ‘the per­sis­tence and in­ten­sity of the symp­toms may neg­a­tively af­fect pa­tient’s qual­ity of life and in­ter­fere with the ac­tiv­i­ties of daily life,’ in fact, ‘chronic re­flux may de­velop a pre-malign con­di­tion called “Bar­rett’s Oe­soph­a­gus,” which in turn evolves into can­cer. The vast ma­jor­ity of lower oe­sophageal can­cers orig­i­nate in chronic re­flux.’

Gas­tro-oe­sophageal re­flux is usu­ally treated in three pro­gres­sive steps. In the first place, a life­style change is con­sid­ered, with a change in diet and use of over-the-counter antacids to re­duce the fre­quency and sever­ity of symp­toms. ‘Weight loss, re­duc­tion or elim­i­na­tion of smok­ing and al­co­hol con­sump­tion, and the mod­i­fi­ca­tion of eat­ing and sleep habits can also be help­ful,’ Doc­tor Bretcha points out.

In case the symp­toms per­sist af­ter these life­style changes, it is pos­si­ble that pa- tients may need phar­ma­co­log­i­cal treat­ment. Antacids neu­tralise gas­tric acids, and over­the-counter med­i­ca­tions re­duce the amount of gas­tric acid pro­duced. ‘Both may be ef­fec­tive in re­solv­ing the symp­toms. Pre­scribed med­i­ca­tions are more ef­fec­tive in heal­ing oe­sophageal ir­ri­ta­tion and al­le­vi­at­ing the symp­toms, though be­fore start­ing treat­ment, pa­tients must con­sult their sur­geon,’ warns the La­paro­scopic surgery is highly ef­fec­tive in treat­ing gas­tro-oe­sophageal re­flux, and defini­tively elim­i­nates the need for med­i­ca­tions that, in the long term, cause side ef­fects. As Doc­tor Blas Flor ex­plains, ‘the surgery is per­formed un­der gen­eral anaes­the­sia, and con­sists of build­ing a full or par­tial cuff, us­ing the stom­ach, around the oe­soph­a­gus, plac­ing it be­low the di­aphragm. In or­der to do this, we make small in­ci­sions, only mil­lime­tres in size, in or­der to ac­cess the ab­domen through the la­paro­scope, which con­nects to a small video cam­era to fully view the ab­dom­i­nal cav­ity.’ Among the ad­van­tages of the la­paro­scopic ap­proach, we can in­clude a re­duc­tion in post-oper- atory pain, min­i­mal scar­ring and quick rein­cor­po­ra­tion to work.

‘Thanks to this in­ter­ven­tion, pa­tients find relief for their symp­toms in nine out of ten cases, and only 15% have a re­cur­rence of the symp­toms af­ter five years. To these ben­e­fits, we must add sus­pen­sion of the med­i­ca­tion, which has been proven, with con­tin­ued use over time, to be as­so­ci­ated to a greater risk of kid­ney dis­or­ders, de­men­tia and hip frac­tures,’ con­cludes Doc­tor Bretcha.

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