Uncovering the Truth About “Acid” Reflux

Chronic acid reflux (gastroesophageal reflux disease or GERD) is a significant and worsening condition affecting millions of Americans. As a result of the persistent obesity epidemic in the United States and worldwide, reflux has affected more and more of the population than ever before. While reflux may seem relatively benign, it can lead to far more severe consequences.

The constant wash of acid from the stomach into the esophagus can create a precancerous condition known as Barrett’s esophagus. This is where the lining of the esophagus begins to resemble the lining of the stomach. A small proportion of those with the condition will eventually develop esophageal cancer, which can be very aggressive if not caught early.

As with many conditions prevalent in modern-day society, there are drugs to address the symptoms associated with chronic reflux. While many patients take antacids as a first line of defense against occasional reflux, proton pump inhibitors or PPIs are usually the go-to medication for those with longer-term persistent reflux. PPIs block acid secretion into the stomach versus neutralizing the acid produced. The result is that the contents of the stomach are no longer acidic. When these juices reflux into the esophagus, they do not do as much damage.

Or so you may think.

While acid is no longer produced in the stomach, caustic base liquids reflux into the esophagus and cause many issues. These alkaline secretions may damage sensitive esophageal lining more than acid. As such, we can add this to the long list of potentially problematic concerns associated with long-term PPI use. As you may know, taking PPIs for longer than the six weeks recommended can increase the risk of bone fractures and the risk of developing harmful bacteria in the stomach and gut.

The Solution

Ultimately, the best solution for chronic reflux is a lifestyle change to include an improved diet and additional exercise. This leads to less weight and lower intra-abdominal pressure. Losing even a few pounds can make a big difference to your reflux. However, as we all know, losing a significant amount of weight and keeping it off is difficult. Therefore, some patients can and should consider surgical reflux treatment called fundoplication. Whether a Nissen fundoplication, which involves wrapping the stomach entirely around the lower esophagus, or a Toupet or Dor, which represent partial wraps, are used, the outcomes are generally excellent. The procedure’s minimally invasive nature means a shorter recovery time and hospital stay with less risk for infection and blood loss.

If you also suffer from morbid obesity, you may wish to consider a gastric bypass procedure which, beyond the weight loss it provides, is very effective for a patient suffering from chronic acid reflux.

If you have been taking PPIs for months and even years, it may be time to consider a surgical solution to your chronic acid reflux. For the reasons stated above, allowing acid or alkaline stomach contents to wash up into the esophagus is not ideal, and it can cause significant problems. Feel free to schedule a consultation with our office so that you can speak to Dr. Higa about the surgical and nonsurgical options for treating Gerd.