How to treat gastroesophageal reflux? Severe cases require surgery

The most common symptoms of gastroesophageal reflux are nausea, belching, regurgitation, renal insufficiency, heartburn, etc. If the gastroesophageal reflux is severe, timely surgical treatment is required. The patient should maintain a good and optimistic mood, pay attention to rest, and adjust the diet in time.

1. Surgical treatment

(1) Indications: ① Major complications of GERD, such as severe esophagitis (Savary-Miller

Ⅲ or Ⅳ or above), failure of esophageal stricture dilatation therapy, short esophagus, ② adequate and systematic drug treatment for more than half a year or one year that cannot relieve reflux symptoms and eliminate complications, ③ esophageal motility disorders (such as achalasia) undergo cardia myotomy to prevent future gastroesophageal reflux, ④ pH monitoring of electrodes under the hypopharynx or UES confirms that recurrent laryngeal and pulmonary complications are indeed caused by reflux, as well as asthma attacks caused by reflux, ⑤ complications caused by gastroesophageal reflux in children, especially frequent pulmonary complications, ⑥ recurrence after surgery and severe reflux symptoms, ⑦ paraesophageal hernia, ⑧ Barrett's esophagus, reflux symptoms, unsuccessful drug treatment; cells have severe atypia or cancer, ⑨ upper abdominal diseases and symptomatic gastroesophageal reflux coexist.

(2) Contraindications: ① Inadequate medical treatment; ② Lack of objective evidence of reflux, especially evidence from endoscopic examination and 24-hour esophageal pH monitoring; ③ It is difficult to confirm whether the symptoms are caused by gastroesophageal reflux. The current symptoms cannot be ruled out as being caused by angina pectoris, gastric disease or biliary disease; ④ Patients with non-gastroesophageal reflux and psychiatric symptoms; patients with suspected reflux symptoms and who have seen others successfully undergo anti-reflux surgery and request surgical treatment; ⑤ Only gastroesophageal reflux without complications; ⑥ Asymptomatic sliding hiatal hernia.

(3) Surgery options:

① Transabdominal approach surgery: A. Most anti-reflux surgeries are designed with transabdominal incisions, B. Other abdominal lesions must be treated at the same time, C. The pain of the surgical incision is less than that of the chest incision and is easier for patients to accept, D. The abdominal incision is suitable for general surgeons, E. Elderly people with poor cardiopulmonary function.

② Transthoracic approach surgery: A. Certain anti-reflux surgeries must be performed through the chest, such as Barrett's esophagus and surgery to correct short esophagus, B. Esophageal stenosis surgery, C. When anti-reflux surgery fails and surgery is repeated, D. Patients who are too obese, E. Esophageal resection and concurrent reconstruction surgery are required, F. Some patients can also treat other upper abdominal lesions through the chest, and the exposure of the surgical field is even better than that of abdominal incision, G. Patients with a history of abdominal surgery may encounter severe abdominal adhesions during transabdominal surgery, H. Paraesophageal hernia is generally treated through a transthoracic incision, I. When the long muscle layer of the esophagus needs to be incised at the same time.

2. Gastroesophageal reflux disease care

①. Maintain an optimistic and happy mood. Long-term mental tension, anxiety, irritability, pessimism and other emotions will disrupt the balance of the excitation and inhibition processes of the cerebral cortex, so you need to maintain a happy mood.

②. Living a moderate life, paying attention to rest, combining work and rest, living an orderly life, and maintaining an optimistic, positive and upward attitude towards life will greatly help prevent diseases. Have regular meals and tea, regular daily life, avoid overwork, maintain a cheerful mood, and develop good living habits.

③. A reasonable diet can include more high-fiber and fresh vegetables and fruits, and a balanced nutrition, including essential nutrients such as protein, sugar, fat, vitamins, trace elements and dietary fiber. It can also help prevent this disease by combining meat and vegetables and diversifying food varieties to give full play to the complementary effects of nutrients between foods.