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December 19th, 2018 Comments

The Lower Esophageal Sphincter

The lower esophageal sphincter plays a crucial role in GERD or acid reflux. GERD is when acid reflux starts occurring more than twice a week. Sphincters are rings on the esophagus, at the top and bottom. The lower esophageal sphincter is a ring at the point where the esophagus meets the stomach. This ring prevents backflow of stomach contents into the esophagus. The LES relaxes briefly during belching and swallowing to allow passage of food and air. When the LES dysfunctions it causes gastro-esophageal reflux disease (GERD) and achalasia. GERD results from the failure of the antireflux barrier and the exposure of the esophagus to gastric acid. This can lead to heartburns, regurgitation, esophagitis and even carcinoma.

Doctors believe that the lower esophageal sphincter can relax and not function properly if there is pressure on the mid-section caused by a hiatal hernia, eating large meals or obesity. Overtime, acid reflux can damage the lining of the esophagus, potentially leading to cancer. The abnormal change in cells in the esophagus due to the reflux is known as Barrett's esophagus, a precursor to cancer.

Patients suffering from frequent and chronic heartburn must speak to their doctors. In some cases, lifestyle changes can alleviate GERD symptoms, but others may require medication or surgery. Refluxmd has plenty of information on the lifestyle adjustments that are needed to manage GERD.

Medication and surgery

Doctors prescribe antacids, H-2 receptor blockers and proton pump inhibitors as medicines to GERD patients. However, if the symptoms have been around for long and waiting would put the patient at risk; the doctor may advice certain surgical procedures. Moreover, the proton pump inhibitors or PPI's have come under scrutiny due to worrisome side effects. Other procedures may vary based on the case. The following are the procedures performed on GERD patients:

Stretta procedure

Also known as the radiofrequency treatment, high-energy waves are directed into the wall of the lower esophagus to create scar tissue. This will help the LES in performing its functions. This procedure usually reduces heartburn and other symptoms of acid reflux.

Nissen Fundoplication Surgery

The main surgery for GERD or stubborn heartburn is called the Nissen Fundoplication. The Nissen Fundoplication surgery is a surgical procedure performed to treat a hiatal hernia and gastroesophageal reflux disease (GERD). It was first performed by Dr. Rudolph Nissen in 1955 and the results were published in 1956. It was originally called "gastroplication" but renamed to reflect the doctor's name when it gained popularity in the 1970s.

In this procedure, the gastric fundus or the upper part of the stomach is plicated or wrapped around the lower end of the esophagus. This strengthens and reinforces the closing function of the lower esophageal sphincter. As the fundus is plicated, the name Fundoplication is derived. The esophageal hiatus may also be narrowed to prevent a hiatal hernia, where the fundus moves up through the esophageal hiatus of the diaphragm. The procedure is now performed laparoscopically, which doesn't require large cuts.

GERD is a manageable disease but requires care. Details on all possible procedures to treat GERD can be viewed on Refluxmd.

Author Bio: Reflux MD provides an overview of all reflux treatment. If you are looking for Nissen Fundoplication surgery get in touch with us so that we can guide you based on the lower esophageal sphincter. 

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Tags: Nissen Fundoplication Surgery lower esophageal sphincter


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