Info for GERD sufferers

[BABY1]

TweetSurgery may be best option for treating extreme heartburn

By Howard Wolinsky | Special to the Chicago Tribune September 23, 2008 Most people fight heartburn by taking acid-neutralizing medicine, minimizing consumption of such acid triggers as coffee and chocolate, and not lying down soon after eating.

But these strategies stopped helping Margaret Rietman, 59, of Schererville, Ind., who experienced crushing chest pain mimicking a heart attack last spring.

For 20 years, Rietman has suffered from two related conditions:

•Gastroesophageal reflux disease (GERD) in which the esophagus becomes irritated by stomach contents, including acid, backing up, or refluxing.





•Hiatal hernia, in which the fundus, or upper section of the stomach, protrudes into the chest cavity. Rietman's hernia had become so severe that it caused the chest pain in April.

Forget the Purple Pill. Rietman needed surgery, known as fundoplication. Though her case is somewhat extreme, doctors think that people increasingly may turn to surgery to fix their reflux-related problems.

Experienced surgeons

Dr. Donald O. Castell, a gastroenterologist and director of the Esophageal Disorders Program at the Medical University of South Carolina, said many gastroenterologists may be reluctant to recommend surgery for GERD. But the success of the surgery by experienced surgeons may win them over.

Castell, editor of "The Esophagus," the primary medical text on these problems, said, "The average practicing gastroenterologist sees [surgical] patients who have had problems. They don't see the successes."

He stresses that patients get the best results from seeing a surgeon with a lot of experience, ideally a minimum of 30 operations a year.

Rietman didn't have to look far; she's a faculty secretary at the University of Chicago Medical Center. She asked around and found Dr. Marco Patti, a gastrointestinal surgeon, who recently left the University of California at San Francisco to head up the U. of C. Center for Esophageal Diseases.

200 procedures per year

Patti, who performs about 200 of the procedures a year, said medications help up to 95 percent of the 40 million Americans with GERD. "But that leaves a lot of people who actually would do much better with an operation," he said.

In addition to heartburn and reflux, these patients may have respiratory problems, such as coughing, wheezing and asthma, and hoarseness. And for patients such as Rietman with large hiatal hernias, Patti said surgery is the only option.

During an hourlong, minimally invasive operation, the surgeon makes five keyhole incisions at the waistline and below the rib cage through which instruments and a camera are inserted. The surgeon uses the tiny instruments to wrap the fundus around the lower esophagus as he watches on a TV screen.

"It looks like a doughnut around the esophagus and basically reinforces the valve that is between the esophagus and the stomach and stops the reflux," Patti said.

When patients have a hiatal hernia, the surgeon will fix it as well. Patti said complications such as bleeding and anesthesia problems are very rare. Patients typically return to work in two weeks.

Patti said that for about two to three months after the operation, patients feel full with small amounts of food. He said patients typically lose 10 pounds. Rietman said she dropped 18 pounds. Weight loss also helps control reflux.

There can be postsurgical problems. Castell said that if the stomach wrap is too tight, it makes it difficult for patients to belch. He said this results in patients' feeling bloated and passing a lot of gas.

Castell said GERD patients whose problems have been controlled with medicine potentially could become surgical candidates. He said that while these medications are very safe, research recently has raised questions about whether proton pump inhibitors, including such widely used medications as Prilosec, Prevacid and Nexium, may interfere with calcium absorption and put the patient at risk for fractures.

[firstenrgy]

TweetGood info. Thanks for the post.

Iv'e suffered from gerd/excess acidity for years now and take zantach (ranatidine) 150mg 2X a day.

THE BEST ANTACID if you have "heartburn" is baking soda. 1tsp mixed in 8 oz of water will nuetralize maore acid then 20 tums. Just some info for fellow sufferers

[BABY1]

TweetMe too and it really sucks! Chocolate and coffee make it so much worse and I love both of them. Prevacid helps me when it really acts up. The baking soda and water does work well, it makes me burp a lot after I drink it.