Understanding Gastric Reflux

What is gastric reflux?

Gastric reflux, also called gastro-oesophageal reflux disease (GORD), is a condition where the stomach’s contents (food or liquid) rise up from the stomach into the oesophagus, a tube that carries food from the mouth to the stomach. Food mixed with the stomach’s digestive acids can irritate and damage the oesophagus.

Anatomy of the Stomach

Food travels from the mouth through the oesophagus, a long, narrow tube that opens into the stomach. This food pipe is lined by muscles that expand and contract to push food down the tube, a process called peristalsis. The stomach secretes acid and other digestive enzymes for the digestion of food and stores food before it enters into the intestine.

A band of muscles called the lower oesophageal sphincter (LES) are present at the junction of the oesophagus and the stomach. This acts as a valve, preventing the reflux of acid and chyme (food mixed with acid and digestive enzymes) from the stomach into the food pipe.

What causes gastric reflux?

Normally, the stomach’s contents are retained in the stomach with the help of the lower oesophageal sphincter (LES), a muscle that contracts and relaxes to maintain the one-way movement of food. However, gastric reflux occurs when the LES weakens. The exact cause of this is not known, however, certain factors including obesity, smoking, pregnancy and possibly alcohol, may contribute to GORD. Common foods such as spicy foods, onions, chocolates, caffeine- containing drinks, mint flavourings, tomato-based foods, citrus fruits and certain medications can worsen gastric reflux.

What are your Options?

Treatment aims at reducing reflux, relieving symptoms and preventing damage to the oesophagus. Some of the treatment options include:

  • Antacids: over-the-counter medicines that provide temporary relief to heartburn and indigestion by neutralizing acid in the stomach
  • Other medications: reduce the production of acid in the stomach
  • Endoluminal gastroplication or endoscopic fundoplication technique: minimally-invasive method that requires the use of an endoscope with a sewing device attached to the end, known as an EndoCinch device. This instrument places stitches in the stomach below the LES to create a plate which helps reduce the pressure against the LES and strengthen the muscle.
  • Laparoscopic fundoplication: is a surgical procedure in which the upper part of the stomach is wrapped around the end of your oesophagus and oesophageal sphincter, where it is sutured into place. This surgery strengthens the sphincter and helps prevent stomach acid and food from flowing back into the oesophagus.

What are your success factors?

The outcome of treatment varies from person to person. Some may experience mild recurring symptoms, while for others, treatment can be very successful. Most people respond well to lifestyle changes and medications. However, a relapse is very common after cessation of medications, so the condition does require monitoring.

When medications fail to resolve symptoms, surgery is recommended. The success rate of surgery is approximately 92%.

What do I do next?

Post-op stages of recovery and care plan

Your surgeon may give you a prescription pain medicine for the first few days to keep you comfortable. Your surgeon may instruct you about your diet and activity restrictions. Care should be taken with your wound. You are advised not to lift heavy objects for 8 to 12 weeks.

Down-time lifestyle or off- work duration

Shortly after surgery, you can gradually resume your daily activities. You are encouraged to start walking as early as possible to reduce the risks of blood clots and pneumonia. You will be able to get back to work in 2 to 3 weeks.