Surgical therapy | What to do against heartburn?

Surgical therapy

A surgical procedure is indicated for very severe and therapy-resistant courses of reflux esophagitis. Complications of the reflux disease may also make a surgical procedure necessary. A diaphragmatic hernia can be treated in different ways.

The aim is to relocate the hernia back into the abdominal cavity. Most operations can be performed by means of laparoscopy.

• Hiatoplasty: First of all, the part of the stomach that has been relocated to the chest is moved back into the abdominal cavity.

  Then the pathologically dilated diaphragmatic gap (hiatus esophageus) is narrowed. In this way, the lower esophageal sphincter is reconstructed.

• Fundopexy: In this surgical procedure the part of the stomach that has prolapsed into the chest is first moved back and then sutured to the diaphragm from below. This prevents the stomach from sliding back into the chest. The surgical procedure of fundopexy is often combined with the surgical procedure of hiatoplasty.
• Fundoplication: In fundoplication, the upper part of the stomach is placed around the lower part of the esophagus and sutured tight. This creates a kind of new esophageal sphincter, which prevents reflux (backflow of gastric acid).

Hoarseness therapy

Since the reflux of gastric acid is the cause of the complaints, the therapy approach is also based on this. With the help of so-called proton pump inhibitors, the production of gastric acid is suppressed. The gastric acid can then continue to flow back into the esophagus and possibly back to the cabbage head, but loses its aggressive and irritating character, which leads to inflammation and causes hoarseness. By sparing the voice, hoarseness can also be improved.Since smoking is an important risk factor for vocal cord inflammation, a stop smoking is also recommended. In rare cases, cortisone is also used for vocal cord inflammation.

Heartburn during pregnancy

About half of all pregnant women develop the symptoms of reflux disease during pregnancy due to the increased pressure in the abdominal cavity. The heartburn, which is perceived as extremely unpleasant and annoying, is not dangerous for mother and child. If the symptoms are unclear or too severe, a doctor should nevertheless be consulted immediately.

There are numerous home remedies that can alleviate the symptoms. Medicines should always be prescribed by a doctor for pregnant women and should not be taken on their own responsibility, as this can endanger the health of mother and child. One reason for heartburn in pregnant women is the increased intra-abdominal pressure, which can cause gastric juice to rise into the esophagus, where it irritates the mucous membranes.

Another reason for the symptoms is the hormonal change. The hormone progesterone, which is produced by the placenta, causes the sphincter muscle between the esophagus and the stomach to close less tightly. This promotes the backflow of stomach acid during the digestive process.

This backflow is then manifested by increased acid burping, burning behind the breastbone, a feeling of fullness and pressure on the stomach. The symptoms may worsen when lying down.