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GERD and Acid Reflux


Dr. Arevalo is a Board-certified Houston,surgeon, and a Fellowship-certified hiatal hernia surgery specialist.

“Heartburn” is a symptom, from gastroesophageal reflux disease (GERD).

What is GERD?

In this condition, stomach acids reflux or “back up” from the stomach into the esophagus. The esophagus lining is not designed to tolerate repeated episodes of acid reflux, and it can cause a burning sensation in the area in between your ribs or just below your neck or throat known as “Heartburn”.

GERD Symptoms

  • Bad breath
  • Sore throat
  • Dry cough
  • Hoarseness
  • A sensation of food retention and regurgitation
  • Backflow of undigested food, especially when belching, bending over, or lying down.

You might have a condition known as gastroesophageal reflux disease (GERD) if you present symptoms of acid reflux more than twice a week. 

What Causes GERD?

When you eat, food travels from your mouth down into a pipe called the esophagus. At the lower end of the esophagus is a muscle valve called the lower esophageal sphincter (LES), right between the esophagus and the stomach. This valve prevents the back up of stomach acid into the esophagus.

GERD occurs when the LES valve does not function properly, allowing too much acid to flow back and burn the lower esophagus.

A Hiatal Hernia will also interfere with the proper function of this valve, leading to GERD and acid reflux. A Hiatal Hernia is a condition where the top part of the stomach bulges above the diaphragm and goes into the chest.
Dr. Arevalo can help you with GERD diagnosis. He is an active member of SAGES and a reviewer of their scientific journal.
Guidelines for Surgical Treatment of Gastroesophageal Reflux Disease (GERD)

Heartburn Treatment and GERD Treatment

  1. Lifestyle modifications 
    •  Losing weight
    • Reducing or eliminating smoking and alcohol consumption
    • Altering eating and sleeping patterns
  2. Medications reduce and neutralize the amount of stomach acid produced. They help in healing the irritation of the esophagus and relieving symptoms, like heartburn, caused by the acid. However, they do not cure the underlying problem or fix a hiatal hernia nor a malfunctioning valve. 
Medications can carry long term side effects like colon infections, dementia, osteoporosis, etc.

Hiatal Hernia Surgery: Dr. Arevalo is a GERD specialist and performs advanced GERD treatments, including scarless surgery.

  1. TIF is an incisionless intervention designed to reconstruct the anatomical components of the Lower Esophageal Sphincter (LES) valve. Its procedure is by using a device called esophyX and an endoscope. The esophyX passes through the mouth into the stomach, where the LES valve is fixed.
  2. Laparoscopic Nissen Fundoplication is done through minimally invasive techniques using small incisions. It involves a hiatal hernia repair, if present, recreating the LES valve, using your tissue by wrapping the top part of the stomach around the end of the esophagus.

The advantage of minimally invasive hiatal hernia surgery approach are:

  • Reduced postoperative pain
  • Shorter hospital stay
  • A faster return to work
  • Improved cosmetic result
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