Reflux
disease

Gastro-Oesophageal Reflux Disease (GORD) is a chronic condition in which
acid from your stomach leaks back up
into your oesophagus.

 
Occasional heartburn is common but does not necessarily mean you have reflux disease or GORD. If you have heartburn more than twice a week then your specialist may diagnose it as GORD. Eventually, you may suffer from more serious health problems if you don’t treat it.
Mr Sanjeeva Kariyawasam
Upper gI surgeon Perth
 

What is reflux or acid reflux?

Gastro-Oesophageal Reflux Disease, or GORD, is a chronic disease. It occurs when your lower oesophageal sphincter does not close properly or opens inappropriately and stomach contents leak back into your oesophagus.

The presence of a hiatal hernia increases the chance of symptoms. No conservative measure will improve a hiatal hernia itself. Here at Upper GI West in Perth, we believe that you deserve the highest quality service. We can help with the diagnosis, perform the necessary tests, such as endoscopy, manage the condition and treat the resistant cases by surgery if required.

Acid reflux

When acid reflux becomes problematic and conservative treatments have not been successful, surgery may be required to alleviate the issue.
“To understand why you may suffer from reflux, it helps to first understand the way you start to digest food. Your oesophagus carries food from the mouth to the stomach. The lower oesophageal sphincter is a ring of muscle at the bottom of your oesophagus. It acts like a one-way valve between the oesophagus and your stomach. This allows food and liquid through but not back, but occasionally it fails.”
Mr Alan Thomas
Upper GI surgeon Perth
When refluxed stomach acid touches the lining of the oesophagus, it can cause a burning sensation in the chest or throat.
“We call this heartburn. The fluid may even be tasted in the back of the mouth. Liquid may spontaneously come up to the mouth from the stomach. This is called waterbrash. Sometimes solid matter also comes back, regurgitation. Together the liquid and solid matter is called volume reflux. ”
Mr Krishna Epari
Upper GI surgeon Perth

Reflux and hiatal hernia symptoms

Reflux may be triggered by many different factors - which may require additional surgical treatment or management. These include:

  • Hiatus Hernias
  • Obesity
  • Alcohol
  • Pregnancy
  • Smoking
  • Certain foods, spices and drinks.

Acid reflux and hiatal hernia symptoms include:

  • Heartburn, or regurgitation
  • Upper abdominal pain
  • Chest pain
  • Difficulty swallowing
  • Painful swallowing
  • Cough
  • Sore throat
  • Sinus issues
  • Chest infections
  • Worsening of asthma
  • Anaemia
  • Vomiting of blood or passing pitch black motions
  • Shortness of breath on bending
  • Shortness of breath on eating large portions

Will I need reflux surgery?

There are a few approaches if you are diagnosed with a reflux condition or reflux disease. First, our reflux specialists may recommend conservative treatment.

This includes changing your lifestyle, losing weight, avoiding alcohol, caffeine and some other foods. Your specialist may also suggest that you use certain medications. Options include antacids such as Quick-Eze, Mylanta, Gaviscon, H2 receptor blockers such as Zantac or Rani and proton pump inhibitors such as Nexium or Somac.

Investigations to diagnose and plan treatment if reflux may include

  • Gastroscopy
  • pH Studies
  • Manometry
  • Barium swallow

If you need surgery our Perth reflux specialists can carry out a laparoscopic fundoplication and/or laparoscopic repair of a hiatal hernia if you have one. From diagnosis to surgical repair you can count on our team of highly trained Upper GI specialists to look at your personal situation, your life and your needs and individualise your treatment.

“Fundoplication can be a very effective surgical procedure to correct reflux. It involves wrapping the upper portion of the stomach around the junction between your oesophagus and your stomach. That way it reinforces the strength of the lower oesophageal sphincter.”
Mr Sanjeeva Kariyawasam
Upper GI surgeon Perth
However, a repair of the hiatal hernia itself may also be beneficial. This is a minimally invasive approach. Your surgeon will use specialised video equipment and instruments to perform the procedure through five tiny incisions. Most of these are less than a half-centimetre in size. This surgery is performed under general anaesthesia.
"One advantage of this method is that you will only have to stay in the hospital for 2-3 days. Other advantages include less pain, so reduced need for medication, fewer and smaller scars and shorter recovery time."
Mr Matt Henderson
Upper GI surgeon Perth

Key Points

Occasional heartburn is common but if it happens more than twice a week it may be GORD
Upper GI West surgeons can perform minimally invasive surgery to control reflux and repair hiatal hernias

Reflux surgery side-effects

  • Difficulty swallowing, known as dysphagia. This is common after surgery and requires patients to follow a modified diet starting with fluids for two weeks and slowly progressing through pureed and soft foods up to the six week mark. If the stomach wrap is too tight for you sometimes an endoscopy and balloon dilatation may be required. Rarely a suture in the hiatus or the wrap needs loosening by repeated keyhole operation.  
  • Gas-bloat & flatulence. A strong and reinforced anti-reflux barrier stops the slow and suruptitious release of gas from the stomach. The gas gets there when we talk, breathe, eat and drink. Some patients find it harder to belch after the surgery. Also, more gas passes through the bowel and can cause bloating and increased flatulence. Consequently, patients with irritable bowel syndrome or motility disorders may experience a worsening of those symptoms.
“Studies show that these side effects can be minimised by performing a partial wrap. This is in place of wrapping the stomach completely around the oesophagus (Nissen or 360-degree fundoplication). We usually recommend a partial fundoplication to minimise the risk of side effects whilst achieving good control of reflux symptoms.”
Mr Sanjeeva Kariyawasam
Upper GI surgeon Perth
“Studies show that these side effects can be minimised by performing a partial wrap. This is in place of wrapping the stomach completely around the oesophagus (Nissen or 360-degree fundoplication). We usually recommend a partial fundoplication to minimise the risk of side effects. This has been found to achieve good control of reflux symptoms.”
Mr Sanjeeva Kariyawasam | Metabolic surgeon Perth

Why Upper GI West?

1

At Upper GI West, we have brought together a team of highly specialised Upper Gastrointestinal surgeons who have undergone at least two additional years of advanced Upper Gastrointestinal training.

2
We have years of experience with complex surgeries in the digestive tract, including surgery to treat reflux and hiatal hernias. This complex surgery is not part of a general surgeons training programme.