B24. Treatment of gastro-esophageal reflux, its clinical manifestation and etiology

Last updated on September 16, 2021 at 15:25

Introduction

For introduction and etiology of GERD, refer to the corresponding pathology 2 topic. For clinical features, diagnosis, and medical therapy, refer to the corresponding internal medicine topic.

Preoperative evaluation

For people being evaluated for surgical treatment of GERD, it’s important to determine that it is actually GERD which causes the patient’s complaints. Patients should undergo upper endoscopy, pH testing, and oesophageal manometry.

Surgical treatment

Surgery is indicated for GERD when standard medical therapy is insufficient to treat the patient’s symptoms. The most commonly performed surgical procedure for GERD is laparoscopic fundoplication, most often the Nissen fundoplication. In Nissen fundoplication, the gastric fundus is wrapped around the lower oesophagus and secured with stitches. This creates a “cuff” around the lower oesophageal sphincter, which prevents reflux.


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