Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.

Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient s age, weight, overall health etc.

Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.

Surgery For GERD - Types, Results and Recovery

Gastroesophageal reflux disease is a condition which occurs due to unhealthy food habits and sudden lifestyle changes. This condition causes the stomach acid to travel in a reverse direction and enter the esophagus. If changes in your food habit and lifestyle do not cure you of this condition, then a surgical procedure is recommended.

What are the different surgical methods of treatment for gastroesophageal reflux disease?
The different forms of surgery that can be used to treat this condition have been explained below:

Fundoplication: Fundoplication is one of the most common surgical methods recommended to patients suffering from gastroesophageal reflux disease. The lower esophageal sphincter or LES is tightened with the help of this surgery. The strengthening procedure is accomplished by wrapping the upper part of the stomach around the outer part of the lower esophagus. Both open and laparoscopic surgical options are available for this surgery.
Transoral Incisionless Fundoplication or TIF: In this surgical procedure you do not have to undergo any incisions. A barrier is made between the esophagus and the stomach. This barrier will work to prevent the acid of the stomach from entering the esophagus. A special device is inserted through the mouth of the patient which helps in creating several folds at the base of the esophagus, these folds form a new valve or barrier. Thus you do not have to undergo any incisions at all if you opt for this procedure. Those who are looking for a non-invasive method to treat their gastroesophageal reflux disease, this procedure is no doubt one of the best.
Bard EndoCinch System: This is a special type of surgery that is accomplished with the help of an endoscope. Although it is not one of the common methods to treat the problem. In this procedure, several stitches will be made in your lower esophageal sphincter so that they result in the formation of valves.
Stretta Procedure: This procedure is also performed with the help of an endoscope. But this is an outpatient procedure and you will be discharged on the same day. A flexible tube is inserted into your esophagus and the other end of this tube has an electrode. This electrode will help in heating the tissues of your esophagus. It will also form small cuts in it. The scar tissue that results from this procedure helps in stopping the acid from flowing in the reverse direction. It also strengthens the muscles that are present in the surrounding area.
These surgical procedures are very successful and have the ability to give you long-term results. Many complications such as the inflammation of the esophagus, can be avoided if you opt for a surgical treatment as a cure for gastroesophageal reflux disease. 

Gastroesphageal Reflux Disease - How Surgery Can Be Of Help?

Bariatric surgery is advised in cases of morbid obesity (BMI >37.5). This degree of obesity is usually associated with comorbidities like diabetes, hypertension, dyslipidemia, obstructive sleep apnea, infertility, knee joint pains, etc. In the present scenario, when all efforts of weight loss seem ineffective, bariatric surgery seems to be the only way to lose excess weight in the morbidly obese patients. Undergoing bariatric or weight loss surgery requires some preparation prior to surgery, and also after surgery to ensure its success.

Most of them will have an enlarged fatty liver, hence a low-calorie diet is advised so that the fatty liver does not pose problems during surgery. Due to obesity, there will be a compromise on the lung function, decreasing the lung capacity. Hence improving the lung function is of importance from the anaesthetic point of view and also concerning the quick postoperative recovery.

For the first few months following surgery, there will be a significant reduction in the intake of food, as the size of the gastric pouch has been decreased. In addition, there will be some restrictions on the caloric density of food for the first few months after surgery. However, for a person who understands these requirements and is willing to so, the long-term benefits are multiple. 

Read on to know how bariatric surgery can turn your life around.

Weight loss: One of the first benefits they would see is weight loss which starts right from the first week following surgery. The patients are so very happy to see this weight loss which they had not seen in spite of all their attempts at losing weight over the last few years. This boosts their morale and helps them to follow the instructions given to them more diligently, as they are seeing results. The weight loss is maximum in the first 6 months following surgery and in fact, this is called the honeymoon period for weight loss. A monthly follow up with the doctor is essential and up to 60 to 70% of the excess weight is lost in the first 6 months. It takes another 3 to 4 months to lose the remaining excess weight.

Emotional gains: For a person who is used to seeing an obese image in the mirror, it is a great morale booster to see that image changing to a slender version. This is a big boost to continue the effort towards diet and exercise, which will only improve the confidence and esteem levels.

Overall health: Morbid obesity is not an isolated condition. It brings with it a host of medical issues including sleep apnoea, diabetes, hypercholesterolemia, etc. With obesity under control, these conditions also begin to improve and the person s overall quality of life begins to improve. This, in turn, provides a big boost for the person to continue working at weight loss.

Reduced healthcare expenses: Obese people often need to eat various medications to manage overall health. There could also be emotional health management issues. With this controlled, the patient spends less on overall health and feels good again.

Social connect: Morbid obesity is both a physical and an emotional blockage for a person to engage socially. Once it is controlled, the person is more confident in meeting people and participating in social activities. This further leads to increased overall happiness.

Active life: With reduced weight, the person s level of activity improves. What seemed difficult earlier is suddenly doable. A person who could not walk some steps is able to, and this is a big booster.

People who undergo bariatric surgery require quite a bit of effort to change their overall lifestyle. However, the benefits are for them to see for themselves, and that is the biggest motivator to continue working towards their goal. Family support is definitely required to boost up the morale. The benefits are there for all to reap.

Bariatric Surgery - Stunning Gains You Must Know!

Hernia surgery is performed for the correction of a hernia which refers to the bulging of internal organs or tissues through an abnormal opening. It is easy to detect hernia through any pain or discomfort while lifting heavy objects, cough and strain during urination or bowel movements or during prolonged standing or sitting. It can be found in both men and women. The Hernia can be congenital or can be developed over a period of time. If it doesn t get better over time and also does not go away by itself, then surgery becomes the only option.

Types of Surgery
There are two types of surgery for hernia treatment. One is the conventional open method, which requires an incision in the skin directly over the hernia. The other one is the Laparoscopic hernia repair in which surgery is performed using a small telescope known as a laparoscope. In this type of surgery minimal invasions are made and the hernia is repaired with only small incisions adjacent to the hernia. Most hernia operations are performed on an outpatient basis, which means that you can go home the very same day.

Tips for early recovery

    Wear comfortable clothing with expandable waistbands.
    Keep yourself active by moving around as much as you can as it increases circulation, which further speeds up healing.
    Eat a diet rich in fibre, fresh fruits and vegetables.
    Drink lots of water and other fluids to avoid constipation.
    Do not lift any objects even if it is very light as it can bring back pain.
    Do not to pick up things from the floor as it will be difficult to bend.
    Hold a pillow against your stomach while sneezing or coughing to lessen the pain.
    Use stool softener for a few days before and after surgery to help you with your bowel movements.
    Avoid driving till the time you feel any pain and as long as you are taking narcotic pain medicines.
    Band-Aids which cover the incisions should be changed as and when needed.
    Refrain yourself from intercourse as it can be painful.
    Check with your doctor when to take a shower so as not to hurt your incisions, and make sure to gently dry your incisions and replace the Band-Aids after taking a shower.
    Do not consume any alcoholic drinks for at least 24 hours.

The tips mentioned above will definitely provide help to cope up with post surgery blues. However, in case of fever, excessive sweating, difficulty in urinating, bleeding or any prolonged pain consult your doctor immediately.

Hernia Surgery - 13 Tips to Help You Recover from it

Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or laryngitis
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia 
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications.

Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Should You Know

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

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