Gastroesophageal Reflux Disease (GERD)

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UW Health surgeons in Madison, Wisconsin offer surgical options for the treatment of gastroesophageal reflux disease (GERD). When medications fail to control GERD, patients often look to surgery for relief of their symptoms.


What is Gastroesophageal Reflux Disease (GERD)?


Gastroesophageal reflux disease occurs when partially digested food or bile move from the stomach back up into the esophagus. The valve that opens to allow food to pass from the esophagus to the stomach functions improperly, causing heartburn and a sour taste in the mouth. About 20 percent of Americans have experienced GERD at some time or another.


What are some of the symptoms?

  • Heartburn
  • A sour or bitter taste in the mouth
  • Feeling of food stuck in throat
  • Regurgitation of stomach acid in the throat
  • Bad breath
  • Coughing
  • Hoarse voice

What are the risks of GERD if left untreated?


If left untreated, GERD can lead to esophageal ulcers, esophagitis or Barrett’s disease.


How is GERD treated?


In most cases, GERD can often be managed through a combination of medication and lifestyle changes. Lifestyle changes may include quitting smoking, limiting alcohol and caffeine intake, avoiding certain foods (usually foods that are fried, acidic or spicy), not eating before bed, improving posture and losing weight.


In some cases, however, changes to lifestyle and medication are unable to manage GERD and surgery is necessary. 


Surgical Options for GERD: Laparoscopic Nissen Fundoplication (LNF)


The most common surgery performed for GERD that does not respond to medication is laparoscopic Nissen fundoplication (LNF). A Nissen fundoplication is a type of fundoplication during which the surgeon wraps the upper part of the stomach (fundus) around the lower esophagus to create an antireflux valve, allowing food and drink to go down into the stomach but preventing stomach contents from flowing back up into the esophagus. Traditional laparoscopic Nissen fundoplication involves five to six small incisions (5-12 millimeters) in the abdomen. 


Surgical Options for GERD: Transoral Incisionless Fundoplication (TIF)


Transoral incisionless fundoplication (TIF) is an incisionless surgical procedure that introduces a device transorally - through the mouth - that fastens tissue in the esophagus to create a naturally functioning valve.


Transoral incisionless fundoplication as performed by UW Health surgeons involves the EsophyX device. The device is positioned at the gastroesophageal junction, where it wraps around the esophagus and creates a fold. Repeated several times, this procedure reconstructs a tight valve that prevents stomach contents from flowing back through the esophagus.


Surgical Options for GERD: Implantation of LINX® Reflux Management System


UW Health surgeons may implant the LINX® Reflux Management System as a surgical option to prevent gastroesophageal reflux disease. The LINX® system is a small ring made of interlinked titanium beads that surgeons implant using a minimally-invasive, laparoscopic technique. 


After implantation, the LINX® system's magnetic beads constrict to bolster the existing structure of the esophagus and prevent gastroesophageal reflux. But the LINX® system does not inhibit eating. The magnetic beads relax during swallowing, allowing food to pass through the esophagus to the stomach.


The LINX® Reflux Management System received FDA approval in 2012 for use in patients diagnosed with GERD.


Learn more about the LINX® Reflux Management System