When is surgery needed for Gastroesophageal reflux disease GERD? - Dr. Lorance Peter скачать в хорошем качестве

When is surgery needed for Gastroesophageal reflux disease GERD? - Dr. Lorance Peter

Majority of the patients with gastroesophageal reflux disease or what we call as reflux disease is a very common disorder and does not require surgery. Majority of them can be treated by proton pump inhibitors once a day or twice a day. Along with other lifestyle modifications like weight reduction or dietary control and lifestyle changes. Some patients may require proton pump inhibitors or prokinetics or symptoms relief. Few patients will require surgery. These are 5 to 10% of patients will require surgery, even less than that. These are the patients with large amount of acid reflux because of very lax GE junction, large hiatus hernia, and patients who have significant acid reflux and symptoms which does not respond to treatment or patients who do not want long term medications. So they are the candidates who require long term medications. So they are the candidates who require surgery. If there is a large hiatus hernia, obviously this patient is not going to benefit from surgery. If there is significant regurgitation while sitting up or standing because there is hiatus hernia or there is a poor low LES reassure, these patients will respond form surgery. So there are some parameters which will tell us which are the patients that will respond well to surgical management of reflux disease. If there is a high baseline acid exposure documented by a 24 hours pH monitoring, presence of hiatus hernia, absence of significant dysmotility of the oesophagus, the patients who do not want medications for reflux disease, they are the ones who go for surgery.