Heartburn Surgery in the Gold Coast
Dr Harald Puhalla Offers Heartburn Surgery on the Gold Coast
Reflux or heartburn is also called Gastro – Oesophageal – Reflux – Disease (GORD). The typical symptoms of heartburn is when the stomach acid backs up from your stomach into your oesophagus (food pipe), causing a burning sensation just below your neck, behind your chest bone or between your ribs. The feeling may spread into the throat or chest. Other possible symptoms include difficulty swallowing, vomiting, and a chronic cough.
What You Should Know About GERD
GORD has several potential causes. Usually the junction of the oesophagus (food pipe) and the stomach does not function properly. It is not tight enough and let content from the stomach reflux into the food pipe. This condition is often associated with a Hiatus Hernia (Hiatus is the natural opening in the membrane (diaphragm) which separates the chest from the abdomen. The food pipe passes through this hiatus from the chest into the abdomen and enters the stomach) A Hiatus Hernia means that part of the stomach is sliding through the hiatus up into the chest causing a weakness of the food pipe / stomach junction. A hiatus hernia can be only a few centimetres small or sometimes a large amount of the stomach can glide into the chest. Regardless of the cause, however, GORD is a condition that should be treated especially if it occurs frequently. Some of the possible treatment options are:
- Lifestyle changes. In many cases changes in diet can reduce the frequency and severity of your symptoms. Losing weight and quitting smoking can also help.
- Drug therapy. Antacids can neutralise stomach acids. If over-the-counter antacids are not effective in relieving your symptoms, prescription medications may be the solution, as they may be more effective.
- Surgery. If you do not respond well to medications or lifestyle changes and still experience symptoms, then your doctor may recommend surgery to treat your GORD. Surgery is very effective at treating GERD and is performed using minimally-invasive techniques. Hiatus Hernia
Anti – reflux Surgery During an anti – reflux operation the hiatus hernia needs to repaired where the stomach is pulled back into the abdomen and the hiatus, which has been too wide is narrowed down to a normal size, so that the food pipe fits through easily but the stomach can’t slide up. As a next step part of the stomach (fundus) is wrapped around the food pipe/stomach junction (this is called fundoplication) to reinforce the junction to reduce further reflux. Depending on different conditions the fundoplication can be a complete 360 degree or a partial wrap.
What type of fundoplication may suit you best and the pros and cons of each type will be discussed by Dr Harald Puhalla with you during your consult. The procedure is performed with keyhole technique which helps with a quick recovery. Further advantages of minimal invasive keyhole technique in antireflux surgery:
- Less pain after surgery. Patients typically require long-term pain medication while they heal from a large incision. The smaller incision means an easier recovery with less pain.
- Smaller scars. Smaller incisions naturally lead to smaller scars. Larger incisions are also more likely to become infected, and infection is not only dangerous but can also lead to larger scars. Hiatus or Hiatal Hernia
- Shorter hospital stays. Because healing is so much faster with the keyhole technique, patients need to stay in hospital less time than with open surgery, sometimes being discharged on the same day as or the day after their procedure.
What to Expect After a Laparoscopic Anti-Reflux Operation
After a minimal invasive anti-reflux operation patients stay in between 1-3 nights in hospital in the hospital, the nurses will monitor your healing, diet, and activity. Once you return home, here’s what you can expect as you recover.
- Light activity. You will need to avoid heavy lifting for four to six weeks after your procedure. You should increase your activity level gradually with your doctor’s okay. Walking is good exercise that will keep your blood circulating and your lungs clear.
- A soft / slippery diet. For a few weeks after surgery Dr Harald Puhalla recommends a “soft/slippery diet” which will be discussed with you by an experienced dietitian while you are in hospital. Generally this means avoiding carbonated beverages, caffeine, citrus drinks, food should be very soft and be eaten slowly. It is wise to stay on this diet until your follow- up appointment.
- Incision care. There may be some swelling around the incision, but let your provider know if you experience excessive swelling or fever, bleeding, or pain that increases.
- A follow-up appointment. Your follow-up appointment is usually about a week after your procedure. Your doctor will make sure that you are making good progress in your recovery and that everything is healing well.
Always follow your doctor’s instructions regarding wound care, diet, and activity Postoperative Patient Information.
Some patients may have been diagnosed with Barrett’s oesophagus (a specific change in the inner lining at the junction of the food pipe to the stomach) before their anti-reflux operation. This condition would still require ongoing surveillance with a gastroscopy despite successful surgery.
Investigations before a Hiatus Hernia repair with Fundoplication to get a detailed information how severely your food pipe is potentially affected by the reflux (GORD) and find out the size of the hiatus hernia
- Gastroscopy. During a gastroscopy a camera is put through your mouth into your food pipe and stomach, often very small tissue samples are taken which you can’t feel. For this procedure you are in twilight anaesthetic, it will take 5-15 minute and you go home the same day (day procedure). We strongly suggest that you don’t drive on the same day of the gastroscopy. It is considered a very safe procedure (https://www.mayoclinic.org/tests- procedures/endoscopy/about/pac-20395197).
- Contrast Swallow. For this procedure you need to drink a fluid. While you swallow some X- rays are taken. Therefore this is an investigation performed at an X-ray institution. It used to investigate how well food passes through your food pipe into your stomach, if stomach content refluxes back into the food pipe and can help to diagnose a hiatus hernia.
- pH / Manometric Test. This is a test which can be used for complex GORD symptoms if necessary. For 24h your reflux and GORD symptoms are recorded.
What Sets Dr Puhalla, General Surgeon Apart Regarding GORD
When you need any surgery, it’s essential to find a reputable, experienced surgeon who has performed many similar operations in the past. Dr Puhalla, General Surgeon, will assess in detail your symptoms and in conjunction with your life style discuss the surgical options with you to find the procedure which will suit you best. Hoffers a range of surgeries including, weight-loss surgery, hernia and gallbladder removal and more. Some of the things that set us apart include:
- Experience. Dr Puhalla began his surgical training in 1995 and has nearly 25 years’ experience performing a variety of procedures.
- Unmatched care. We care deeply for our patients and provide not only exceptional care before and during their procedures but after as well.
- Minimally-invasive procedures. We offer minimally-invasive methods using the “keyhole” technique to ensure less postoperative pain, shorter hospital stays, less downtime, and the best possible result.
We are invested in our patients’ results and strive to give them the very best medical care available at every opportunity.
About Dr Puhalla, General Surgeon
Dr Harald Puhalla, General Surgeon, offers treatment options for a variety of conditions including GORD, obesity, hernias and gallbladders, liver and pancreas cancer using minimally-invasive techniques for the lowest possible risk. We are based at the Gold Coast Private Hospital and Pindara Private Hospital for our patients’ convenience. If you are experiencing reflux/GORD symptoms and think that surgery might be a good option for you, don’t hesitate to contact us for a consultation and discuss your condition and treatment options.