Gastroesophageal reflux disease

Adresse

Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

Gastroesophageal reflux disease is a common disease, affecting 10-20% of the population. It can cause erosion of the esophagus (reflux esophagitis) with consequences such as stenosis or precancerosis (Barrett's esophagus).

Medical treatment of gastroesophageal reflux disease

The management of gastroesophageal reflux disease is in general based on temporarily or lifelong antacid medication . The treatment also requires following hygienic-dietetic rules, such as weight loss, elevation of the head in the bed (to prevent reflux), avoidance of late evening meals, limitation of consumption of tobacco, alcohol, fatty and/or spicy foods, chocolate and coffee.

In case of an unsatisfactory response to drug treatment or in the presence of, for example, dysphagia , additional examinations such as gastroscopy are recommended. In certain situations, pH monitoring as well as manometry must also be carried out. If the acidic origin of the symptoms is confirmed, the medical treatment can be intensified by adding other drugs, such as other antacids, baclofen or visceral analgesics.

People with Barrett's esophagus should be monitored regularly by the gastroenterology team, with follow-up using  gastroscopy, and sometimes undergo treatment to eradicate the abnormal tissue. 

Surgical treatment of gastroesophageal reflux disease

Patients who do not respond to medical treatment or suffer from severe gastroesophageal reflux disease may require surgery. Performed under general anesthesia by laparoscopy with robotic assistance, or by laparotomy , the operation consists of a fundoplication to prevent acid reflux. The fundoplication is either partial (the stomach is wrapped around the esophagus at 270 0 , intervention of Toupet), or complete (the stomach is wrapped around the esophagus at 3600, intervention of Nissen).

Gastroesophageal reflux disease
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Ascent of acid from the stomach causing discomfort: burning sensations starting from the stomach toward the mouth (pyrosis), regurgitation or coughing.
Stenosis
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narrowing
Precancerosis
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precursor stage of cancer
Antacid medication
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drugs reducing gastric acidity
Dysphagia
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Difficulties in swallowing food which may cause pain or a sensation of mass.
pH monitoring
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Real-time measurement of the acidity level (pH), for several hours, using a probe placed in the esophagus.
Manometry
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Real-time measurement of the pressure in an organ using a probe.
Gastroesophageal reflux disease
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Ascent of acid from the stomach causing discomfort: burning sensations starting from the stomach toward the mouth (pyrosis), regurgitation or coughing.
Laparoscopy
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A surgical technique using small incisions and insertion of a camera
Laparotomy
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Open surgery of the abdomen
Fundoplication
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Involves creating a gastric valve by wrapping the esophagus with a part of the stomach to strengthen the esophageal sphincter and prevent acid reflux.

More information

Last update : 04/01/2022