Taking Control of Your Chronic Reflux With Memorial Hermann

This article is promoted/partner content and not produced by the editorial staff.

We’ve all been there where we ate a little too much or had a super spicy meal and next thing you know, you’re experiencing reflux. But, what about the people who walk around with reflux all day, every day? A feeling that just never goes away? That’s where Dr. Felix Spiegel and his colleagues at Memorial Hermann step in.

“Chronic, debilitating reflux is not just the occasional reflux people have if they ate something spicy,” explains Dr. Spiegel. “This is reflux that people have almost on a daily basis that lasts for many hours – if not all day – despite taking many medications for it. It really affects their quality of life and makes it hard to eat, function, or sleep. That’s why it’s so life-changing when it’s treated.”

Breaking Down Reflux

Reflux (also called “acid reflux”) occurs when acid flows backward from your stomach up into your esophagus or throat. When you eat or drink, food and liquids should travel from your mouth through your esophagus and into your stomach and digestive system, in a downward direction. The upward motion of acid is not normal and leads to gastrointestinal distress or more serious medical conditions.

The first step to feeling better is an accurate diagnosis. Because reflux is a broad term for a range of more specific conditions, it is extremely important to understand the precise cause of symptoms. Choosing the right surgeon and hospital system is critical to achieving lasting results from reflux surgery. The physicians affiliated with Memorial Hermann are at the forefront of the latest techniques and are dedicated to identifying the best possible option for each patient’s individual needs.

Types of Reflux

What patients describe, generally, as reflux may actually be a specific condition including gastroesophageal reflux disease (GERD), dysphagia, gastroparesis, or esophagitis. There is no one-size-fits-all approach to treating reflux. The best treatment option depends on accurately identifying the underlying cause. The abnormal movement of acid through the intestinal system can lead to a number of conditions that require treatment. Reflux is often associated with the following conditions.

Gastroesophageal Reflux Disease (GERD)

Chronic acid reflux that reaches the esophagus, affecting approximately one-quarter of the population. GERD is caused by mechanical abnormalities in the gastrointestinal system and requires medical intervention to control. When over-the-counter or prescription medications do not provide relief and the problem is ongoing, the condition is known as refractory GERD.

Laryngopharyngeal reflux

Chronic, persistent acid reflux reaches all the way up into the throat causing hoarseness, coughing, or difficulty swallowing.

Dysphagia

Difficulty swallowing is caused by muscular or nerve abnormalities. Patients may experience food becoming stuck in the throat or esophagus.

Esophageal stricture

Narrowing of the esophagus leads to difficulty swallowing. Patients may experience chronic coughing, choking, regurgitation, or weight loss.

Barrett’s esophagus

Damage and inflammation of the esophagus are caused by prolonged acid reflux. Patients are at an increased risk of developing esophageal cancer.

Hiatal hernia

Small hiatal hernias may not cause symptoms, but if the affected area is large, it can lead to chronic reflux and damage to the esophagus.

Achalasia

A rare swallowing disorder caused by nerve damage in the esophagus causes food to come back up through the esophagus rather than being deposited into the stomach.

Moving Forward

If any of these sound like you, Dr. Spiegel explains it’s easy to get the help you need. His patients start with an initial appointment for a consultation about their lifestyle and symptoms, moving into an upper GI x-ray that evaluates the passage of liquid through their system. If it’s suspected that they do have chronic reflux, Dr. Spiegel will order an endoscopy to confirm the findings. 

If confirmed, patients are then scheduled for surgical repair. This is dependent on what type of surgery you need, but a hiatal hernia repair is typically about a one-hour, outpatient procedure and requires only a few days off work before returning to a normal schedule. Many patients are surprised to learn that reflux surgery is routinely performed with positive, long-lasting results and minimal side effects. This field of surgery has been heavily researched and recent advancements and innovative options deliver proven, effective results.

“By doing this relatively quick procedure, we can greatly increase someone’s quality of life, and even decrease their chance of cancer,” said Dr. Spiegel. “If someone walks around with acid for many years, it’s possible to see precancerous changes. So, it’s better to do a few tests to check it out early.”

For most patients, reflux surgery provides better and longer-lasting results than medication. The risks and side effects of reflux surgery vary, based on the type of procedure and the condition being treated. Most patients tolerate the procedures well. Your physician can discuss the specifics of the procedure that is most appropriate for your specific health goals.

Reflux Surgeries

Laparoscopic fundoplication, hiatal hernia repair, LINX, and the POEM procedure are all minimally invasive surgical options that are usually performed in an outpatient setting with quick recovery and little downtime. Gastric bypass has a longer recovery time and may produce additional gastrointestinal side effects.

Like with all medical conditions, different surgical procedures are appropriate for different reflux conditions. Once your physician has diagnosed the underlying cause of chronic reflux, an effective surgical procedure can be recommended to provide lasting relief.

Laparoscopic Fundoplication

This minimally invasive procedure is highly effective at providing symptom relief from GERD. With Nissen fundoplication, the surgeon strengthens the lower esophageal sphincter (LES) by surrounding it with a section of the stomach. Wrapping a portion of the stomach around the lower portion of the esophagus provides additional support for the esophagus to keep acid from coming back up from the stomach.

Gastric bypass

Commonly performed as weight-loss surgery, the gastric bypass procedure is also indicated for patients who experience severe symptoms related to chronic reflux. Gastric bypass (also called “Roux-en-Y”) is a laparoscopic surgical procedure that reduces the size of the stomach and redirects a portion to bypass part of the small intestine. After surgery, the stomach will produce less acid which improves reflux symptoms.

Hiatal hernia repair

Patients with large hiatal hernias often experience reflux that is potentially damaging to the esophagus. For these patients, a laparoscopic surgical procedure to repair the portion of the stomach that protrudes through the diaphragm can reduce the movement of acid and improve symptoms.

Peroral endoscopic myotomy (POEM) procedure

The POEM procedure is appropriate for less common esophageal outlet problems like achalasia. This endoscopic technique involves cutting the muscles at the bottom of the esophagus to create a larger space for food to pass through the esophagus and into the stomach.

LINX

The LINX System is a small flexible band of interlinked titanium beads with magnetic cores, which a surgeon places around the esophagus just above the stomach using a surgical technique called laparoscopy. The magnetic attraction between the beads is intended to help the LES resist opening to gastric pressures, preventing reflux from the stomach into the esophagus.

Following reflux surgical procedures, about 95 percent of patients are symptom-free and no longer require medication. About 85 percent of patients remain medication-free for the next 10 years. Despite reflux’s severity and the success of surgery, Dr. Spiegel explains this condition often goes under the radar because it’s only something his patients feel internally and not something you can see.

“These hernias often go undiagnosed, and people just end up popping acid blockers that they can get over the counter,” said Dr. Spiegel. “In reality, they need a referral to a specialist or surgeon who can diagnose and correct the anatomical issue long-term with a simple, outpatient surgery.”

Take the first step toward reflux relief and meet with a Memorial Hermann reflux surgeon.