Many of us have occasional heartburn—especially when we overindulge.
Moderate heartburn can typically be cured with non-prescription antacids.
However, persistent, severe heartburn may be a sign of gastroesophageal
reflux disease, or GERD.
“GERD is a common digestive disorder where stomach acid leaks into
the esophagus, usually because of a weak or damaged sphincter,” says
John Shaver, MD, a board-certified general surgeon at
Some people make the mistake of brushing off recurrent heartburn as simple
stomach trouble, putting themselves at risk of long-term effects.
“Repeated exposure to stomach acid can damage the sensitive lining
of the throat and esophageal damage increases the risk of more serious
health problems, including ulcers and ‘Barrett’s esophagus,’
which can be a pre-cancerous condition,” Dr. Shaver says.
Now, exciting innovations in minimally invasive surgery offer the promise
of long-term relief from GERD—without the potential downsides of drugs.
GERD drugs only treat the symptoms
Aside from lifestyle changes, such as avoiding trigger foods and not eating
late in the evening, GERD is first managed with medications—especially
drugs called proton pump inhibitors, or PPIs. Popular brand names include
Nexium, Prilosec and Prevacid.
By limiting the production of stomach acid, these medications can deliver
dramatic positive results quickly, but there are limits. Dr. Shaver says
there are two major drawbacks to PPIs:
- They only attack the symptoms of GERD, not the root cause. “PPIs
do not repair the damaged lower esophageal sphincter,” Dr. Shaver says.
- More troubling, researchers have identified a growing list of adverse side
effects with PPIs—from relatively benign problems like chronic magnesium
deficiency to serious issues like kidney disease and dementia.
Antireflux surgery uses advanced technology for fast healing
Most antireflux surgeries today are minimally invasive or laparoscopic
procedures. Unlike conventional “open” surgery where large
incisions are made, laparoscopic surgery utilizes a narrow, tubular video
camera and several tiny operating instruments inserted into the abdomen
through a few small incisions—each less than a half-inch long. The
surgical team uses the camera to view a magnified image of the surgical
site to perform very precise and delicate operations.
Robotic antireflux surgery is really just an enhanced form of laparoscopic
surgery, but with an extra layer of technology. The surgeon makes the
same small abdominal incisions to insert the camera and instruments. However,
rather than the surgeon directly moving the instruments, the “robot”
holds the instruments while the surgeon sits at a control console a few
feet away, operating the robot.
“Robotic or not, laparoscopic antireflux surgery is much better for
patients,” explains Dr. Shaver. “They experience less pain,
less time in the hospital and faster recovery.”
Other new developments in GERD treatment
In addition to robotic surgery, other leading-edge laparoscopic procedures
are also showing considerable promise of long-term relief for GERD sufferers—including
the LINX system. A small, flexible band of titanium-wrapped magnetic beads
is surgically implanted around the lower esophageal sphincter where it
functions like a supplemental lower esophageal sphincter. The LINX band
expands and contracts—just like a normal sphincter—allowing
food to enter the stomach, but preventing stomach contents from refluxing
back into the esophagus.
Unlike medications, surgical treatments directly address the underlying
cause of the disease, not the indirect symptoms. For most patients, the
treatments are simple outpatient procedures with good outcomes and positive
If you’re picking up a bottle of pink antacid or chalky tablets more
than a few times a week, ask your doctor if you have GERD.
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