Tag Archives: heartburn

GERD and Heartburn (with video)

Gastroesophageal reflux disease

This video and other animations of the digestive system are available for licensing on Alila Medical Media website. Click here!



Gastroesophageal reflux disease (GERD) or gastric reflux disease is  a chronic condition where acid from the stomach flows up and damages the mucosa of the esophagus.
At the junction between the esophagus and the stomach is the lower esophageal sphincter (LES). The LES is a ring of muscle that is generally closed tight to prevent stomach acid from coming up. In normal digestion, the LES opens shortly to allow food bolus passing down to the stomach and closes back tight instantly. GERD occurs when the LES is abnormally relaxed and can not close properly (Fig. 1). Heartburn is a burning sensation in the chest associated with each regurgitation of gastric acid and is the most prominent symptom of GERD. 

Gastric reflux, labeled diagram.
Fig. 1: Abnormal relaxation of the lower esophageal sphincter as cause of GERD. Click on image to see a larger version on  Alila Medical Media website where the image is also available for licensing.

 

 

 

Hiatus hernia is believed to be another cause of GERD. Hiatus hernia or hiatal hernia is a condition where the top portion of the stomach is pulled up forming a herniation above  the diaphragm. This situation somehow compromises the esophagus – stomach barrier and facilitates acid reflux.

Hiatal Hernia
Fig. 2: Types of hiatal hernia. Click on image to see a larger version on  Alila Medical Media website where the image is also available for licensing.

 

 

Treatment

Treatment includes dieting and medication. Proton-pump inhibitors, which act to reduce gastric acid production, are drugs of choice. If these fail, a surgery may be recommended. In a procedure called Nissen fundoplication, the top portion of the stomach is wrapped around the lower part of esophagus and sewn into place. This way, the muscles in the wall of the stomach reinforce the closure of the esophagus. This surgical procedure is particularly recommended when hiatus hernia is present as this can be fixed at the same time. The procedure can be done with minimal invasive laparoscopic technique through small incisions with the aid of a camera.
Nissen Fundoplication Surgery
Fig. 3: Nissen fundoplication procedure.  Click on image to see a larger version on Alila Medical Media website where the image is also available for licensing.

 

 

 

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