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Dr. Darren I. Rohan, FACS
Q. What causes acid reflux?
A. If you have acid reflux disease, also known as gastroesophageal reflux disease, or GERD, stomach acid leaks backward and upward into the esophagus, the tube leading from your mouth to your stomach. This occurs when the valve between the stomach and esophagus weakens. Called the lower esophageal sphincter, or LES, this muscle normally provides a tight seal between your food tube and stomach, permitting only one-way downward movement. But when it is weak, corrosive stomach acid can splash back into the esophagus.
Q. What can cause your LES to weaken?
A. Genetics can play a role. In addition, cigarettes and certain foods – including coffee, chocolate and citrus fruits – contain chemicals that can weaken the LES, or gatekeeper valve. A hiatal hernia can also cause acid reflux. In this case, part of the stomach enters the chest, moving the LES into the chest area from the abdomen, where it functions best.
Q. What are some of the “large spectrum of symptoms” connected with acid reflux?
A. Heartburn is the common term for the sharp pain people feel in the chest. Or, you may feel mild pain in the chest or upper belly. You are most likely to have symptoms when you eat or drink, and when you sleep or lie flat. Not only does eating stimulate your stomach to produce acid, but acid content in the food itself can further irritate the esophagus walls. When you lie in a facedown position, gravity no longer keeps stomach acid where it belongs. Less common symptoms include nausea, vomiting, general upset of the gastrointestinal tract and bloating.
Q. If left untreated, can acid reflux cause major damage?
A. Severe acid reflux disease can cause respiratory symptoms like chronic coughing, pneumonias or asthma. In about five percent of cases, acid reflux leads to Barrett’s disease, a pre-cancerous chronic irritation of the esophagus. Barrett’s disease is detected through an endoscopy, a non-surgical procedure used to examine the digestive tract. People with severe reflux should get regular surveillance with endoscopies.
Q. If I have acid reflux, what are my treatment options?
A. Most people with acid reflux disease are treated successfully with over-the-counter medications. But, it’s important to understand that medications do not stop the refluxing action. All they do is reduce the amount of acid in your stomach. Other options include lifestyle changes – not drinking coffee, avoiding chocolate and losing weight – and finally, surgery.
Q. What does surgery for acid reflux entail?
A. Severe acid reflux disease typically requires a surgical remedy. If you have a hiatal hernia, we fix the hernia, and then wrap a portion of the relocated stomach around the lower esophagus to create a new strong valve. If there’s no hernia, we only perform the wrap. The procedure, called a nissen fundoplication, is performed at Northern Westchester Hospital using robotic surgery. The robot’s highly flexible tools and superior visualization lead to better patient outcomes and a quicker recovery. Post-surgery, there is a very low chance that the LES will weaken again.
Learn more about Dr. Rohan
Westchester Regional Director, Thoracic Surgery Program
Northern Westchester HospitalNorthern Westchester Hospital is a proud member of Northwell Health.
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