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It is normal to occasionally get acid reflux or heartburn.
However, when it occurs frequently enough to cause significant discomfort, injury to the lining of the oesophagus or changes that can potentially lead to oesophageal cancer, treatment is warranted.
Initial treatment should always be with anti-acid medication. However, when medication is inadequate at controlling acid reflux symptoms and damage is occurring to the oesophagus, anti-reflux surgery may be indicated to control symptoms, allow healing of the oesophagus, prevent further damage or allow potentially cancerous change to regress.
Surgery is performed under a general anaesthetic and key-hole surgery.
5 small incisions will be made on the abdomen for the camera, instruments and liver retractor.
The bottom part of the oesophagus is dissected free from the diaphragm opening (the "hiatus") to ensure that the junction of the stomach and oesophagus easily remains in the abdomen. The hiatus is repaired snug around the oesophagus and then the top part of the stomach partially wrapped around the bottom of the oesophagus to help create an anti-reflux valve.
The surgery is extremely effective in controlling acid reflux and the majority of patients will come off anti-acid medication at 1 month after surgery.
The surgery is generally very well tolerated and many patients will be ready for discharge after one night hospital stay.
You will be discharged on a modified diet for a month, moving from liquid to a puree diet, then puree diet to a soft diet.
Most people will be off work for 2 weeks, and it is recommended that you do not do any heavy lifting for at least 6 weeks.
Many people will just have Panadol for pain relief, with some needing a few doses of stronger painkillers for the first few days.
Swallowing difficulties can sometimes occur as a result of creating an anti-reflux valve.
Increase frequency of gas bloating and passage of flatus can occur after surgery.
Injury to other organs, particularly the spleen and major bleeding are rare.
The vagus nerves which control acidity and motility for the stomach can potentially be injured causing slow gastric emptying.
Hiatal hernias or reflux symptoms can potentially recur over time and there is a chance that anti-reflux medication may be required again in the future.
Some people can experience dumping symptoms (diarrhoea after eating) due to increased gastric emptying due to the fundoplication.
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