Acid Reflux Disease is so common — some experts estimate one third of all Americans suffer with it. For many people, the condition can be managed with …
– When you pump gas into
your car's gas tank,
a valve keeps the gas
from splashing back out.
The same kind of valve operates
in your digestive system,
allowing food to go down,
but not come back up,
unless there's a problem.
It's called acid reflux.
And in tonight's Medical Spotlight,
David finds out why more than ever before,
doctors are turning to surgery to fix it.
– Thanks Paige, here with me tonight is
Dr. Eric Castaldo of The
Surgical Group of Gainesville,
practicing at North Florida
Regional Medical Center.
What are the first steps
for treating acid reflux?
– Well typically when
someone has acid reflux
associated with heartburn,
the initial steps are to have
the patient stop smoking,
do other things such as
stop their caffeine intake,
or try and reduce it,
as well as sometimes you have them
elevate the head of their bed.
Also instruct them not to eat,
and then immediately go lay down.
In addition to these
non-medicine therapies,
there's also medicines that sometimes we
prescribe to people as well
in order to control their
acid reflux symptoms.
– We see their commercials
all the time on television.
Aside from some of the discomfort
that a patient might
feel with acid reflux,
what are some of the
longer term difficulties
that could arise?
– Well sometimes when patients
have long standing reflux,
they can develop what's
called Barrett's esophagus
in their lower portion of their esophagus,
so when the esophageal sphincter,
which is like a valve at
the end of the esophagus,
doesn't quite work,
the lower portion of the esophagus
sort of feels like it's,
after being exposed to acid,
it transforms and
becomes what's more like,
if you look at it under a microscope,
it looks more like what the stomach
would look like under a microscope.
This is called Barrett's esophagus.
This can lead to occasionally
a cancerous condition,
or cancer of the lower esophagus.
– So obviously serious conditions here
if it's allowed to go on.
– Correct. Very serious.
– At what point is surgery indicated?
– So for patients who
are medically refractory
to their medications,
people that cannot tolerate medicines,
in addition, sometimes younger patients,
you might opt for surgical
therapy more often,
because the long-term costs
of keeping patients on
some of these medicines
can sometimes be outweighed
by performing surgery early.
– Mmm. So how is this
surgery actually performed?
What happens when you go in there?
– So typically what we do is
we can do this usually laparoscopically,
where we free up the stomach,
and bring the stomach
into its proper position,
and then wrap the upper
portion of the stomach
around the esophagus,
typically in a 360 degree fashion,
or in a full circle,
that's called a Nissen fundoplication,
and that is, basically what it does is
recreates the valve that
is no longer working,
so that when a patient fills up
with food or air in their stomach,
it essentially closes the esophagus tight.
– And this wrap, is it understood,
the surgery's been done
for a number of years now,
how long is it expected to last?
– So it has about a 90
to 95% success rate.
– With the surgery, do we
know, is it gonna last forever,
I mean is that it for me?
– For most folks, that's the goal,
is for about 90 to 95% of
those people should hopefully
be off medicines and symptom free.
– Okay real good.
Thank you so much for joining
us, Dr. Eric Castaldo,
in tonight's Medical Spotlight.

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