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Erosive Esophagitis: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

The treatment process of erosive esophagitis can vary depending on the cause of the disease. If it is a result of chronic acid reflux, doctors will prescribe proton pump inhibitors, which are a type of drug that help in the reduction of the production of stomach acid. On the other hand, if this disease is caused by the swallowing of a corrosive substance, then the treatment will depend on what the patient had swallowed. In severe cases, the patient maybe hospitalized and kept in ICU to bring about treatment for the disease. Often times, surgery may also be performed for the successful treatment of erosive esophagitis. Other forms of non-invasive treatment methods that can be used to treat this disease include the administration of steroids. However, these treatment methods will not suffice on their own, and the patient will also have to make lifestyle changes in order to completely cure this disease of the digestive tract.

How is the treatment done?

In case the patient is prescribed oral medications, i.e. steroids or proton pump inhibitors, or even over-the-counter medications or prescription strength medications, the patient simply has to ensure the regular oral intake of these before their meals. For patients who have been presrcribed surgery, which is known as fundoplication, they will have to be admitted to the hospital beforehand. Fundoplication is of two types- open fundoplication and laparscopic fundoplicatin. At the start of the laparoscopic surgery, the patient will be administered local anesthesia, after which the surgeon will make a small incision in the belly of the patient and instert the laparoscopic device. During this procedure, the portion of the patient's stomach, which is nearest to the entry point of the esophagus (also known as the fundus), will be gathered by the surgeon and then wrapped band sewn around the lower part of the patients esophagus as well as the lower esophagul sphincter. The process of gathering and sewing of the fundus to the esophagus is known as plication. This surgery will help in increasing the pressure on the lower parts of the esophagus, thereby providing relief from the symptoms of erosive esophagus. The process of fundoplication is the same with the differecne being a larger incision is made and the operation is carried out manuallly.

Who is eligible for the treatment? (When is the treatment done?)

Patients who have tried all other methods of treatment for erosive esophagus but have failed are eligible for surgery.

Who is not eligible for the treatment?

Older patients with other health problems are not the right candidates for surgery. Indiviuals who suffer from unusual symptoms such as weak peristalsis are also not eligible as well as those who have esophagal cancer. Pregnant women are also not eligible for fundoplication

Are there any side effects?

Side effects of proton pump inhibitors are almost non-existent. However, if they do arise, they include nausea, headache, diarrhea, constipation or itching. Side effects of fundoplication are quite a few. The anesthesia used can cause breathing problems, infection as well as bleeding. Post-surgery, patients can suffer from other side effects too such as difficulty in swallowing, heartburn, excess gas and the inability to burp. In certain cases, the wrapped portion of the esophagus can slide out of the stomach as well, which can lead to a recurring of the disease.

What are the post-treatment guidelines?

Generally, after the fundoplication surgery, the patient will be allowed to drink water and eat soon enough, and will even be allowed to go home the next day of the surgery. In the case of an open fundoplication though, the patient will have to stay in the hospital for 5-6 days. Patients can only shower 48 hours after the surgery and can return to work after a week or two weeks at the maximum in the case of laparscopic fundoplication. As for open fundoplication surgery, patients may have to wait a week for bathing and 4 to 6 weeks to get back to work. Patients are generally advised not to lift anything heavy post-surgery for at least 2 weeks in laparoscopic fundoplication and 4 weeks for open fundoplication. Patients will also need to follow special diet as prescribed by their doctor. In certain cases, they may also be asked to continue with their medication after the surgery.

How long does it take to recover?

Patients who have been prescribed medication will take a couple of weeks to recover fully. As for the fundoplication surgery, the total recovery time is two weeks for laparascopic fundoplication and 4 to 6 weeks for open fundoplication surgery.

What is the price of the treatment in India?

The cost of oral medications such as proton pump inhibitors varies from Rs. 20 to Rs. 212. As for the cost of surgery, it varies between Rs. 70,000 to Rs. 1,00,000.

Are the results of the treatment permanent?

The results of oral medications are more or less permanent, however, there are chances of a relapse. As for surgery, in case a complication arises in which the wrapped portion of the esophagus slips out of the stomach, the patient may need a surgery again. If not, the resulst are more or less permanent.

What are the alternatives to the treatment?

The alternatives to the fundoplication surgery are medications such as steroids and proton pump inhibitors. Patients can also go for an endoscopy as that is another viable treatment option for erosive esophagitis. Apart from these, lifestyle and dietary changes have to be made so that the patient can recover fully.

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ACLS,POST GRADUATE COURSE IN RHEUMATOLOGY,Fellowship in Diabetes,MBBS,Post Graduate Course In Rheumatology,MD - Medicine,Masters in Psychotherapy and Counselling
Internal Medicine
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