Gastroesophageal reflux disease or acidity is a very common problem and is called GERD in medical terminology. The problem arises when the stomach acid travels up into the chest through the esophagus or the food pipe. The acid causes pain and burning sensation in the chest. It can also cause an irritating feeling of food being stuck in the chest. The acid may also leak into the airways and affect the vocal cords affecting the voice, causing cough and even asthma. The amount of acid traveling up the food pipe increases when a person lays down to sleep, disturbing the sleep and gives a feeling of acid coming into the mouth which can even cause mouth ulcers in the mouth and damage the teeth. Many people have to stop eating a few hours before going to bed and use extra pillows to avoid the symptoms. The cause of GERD is a poorly functioning valve at the end of the esophagus called the lower esophageal sphincter or LES. We don't exactly know why the LES function gets disturbed however some causes include caffeine, peppermint, chocolates, pregnancies, gallstones, and increased colonic gas. In obesity the increased body weight not only affects the LES but also applies pressure on the stomach forcing the acid up in to the chest. Another reason why the acid starts traveling into the chest could be due to a hiatal hernia. This occurs when the diaphragmatic opening for the esophagus gets enlarged and part of the stomach slips into the chest. As a result the valves like function of the LES gets disturbed and a lot of acid travels into the esophagus. Obesity causes increased abdominal pressure which increases the chances of developing different types of hernias including a hiatal hernia.

At Alsa Pakistan we provide the different treatment options for GERD. Treatment for GERD includes avoiding the foods that cause these symptoms, weight loss efforts and possibly using the medications that block acid production. These medications will reduce the acid content in the gastric juice but will not stop the gastric fluid from traveling in to the food pipe. Another treatment includes a surgery using laparoscopic techniques with small tiny holes and a camera. In this procedure the stomach is returned back into the abdomen and the hiatal hernia is fixed by reducing its size back to a normal one and then the stomach is wrapped around the esophagus to re-create a valve like mechanism that prevents the acid from going up into the chest. This is called a laparoscopic hiatal hernia repair with fundoplication surgery. The fundoplication can be a complete wrap or a partial wrap called Nissen or Toupet fundoplication respectively. At Alsa Pakistan we provide treatment for hiatal hernia and for GERD. However if a patient has GERD symptoms with obesity then the better options include laparoscopic bariatric surgery to treat both the GERD and obesity. The best solution in such a situation is gastric bypass surgery. At Alsa Pakistan we offer all these surgical therapies to treat GERD and obesity and to fix hiatal hernias.