Terri G., 56, had lived for years with severe gastroesophageal reflux disease (GERD). She first tried to settle her heartburn with over-the-counter antacids. With little improvement, her gastroenterologist prescribed stronger medications, but relief was marginal.
The gastroenterologist later examined her esophagus and stomach with an endoscope, a flexible tube with a light and camera. He found that Terri had stomach ulcers and a hiatal hernia. She also had extensive inflammation in the cells lining the inside wall of her esophagus, which occurs when the cells are exposed to refluxed acid over a period of years. They begin to resemble the cells lining the stomach – a condition known as Barrett’s esophagus. Unless treated, these cells have a 30 to 40 percent chance of continuing the transition into esophageal adenocarcinoma, an often-deadly form of cancer.
A nurse for 17 years, Terri had cared for patients with esophageal cancer and she knew what she had to do. She started researching surgeons who specialize in bariatric procedures. Already aware of the highly rated bariatric program at Orange Coast Medical Center, Terri made an appointment with Atif Iqbal, M.D., F.A.C.S., F.A.S.M.B.S., medical director of the Digestive Care Center there. Board-certified and fellowship-trained, Dr. Iqbal specializes in minimally invasive bariatric procedures and digestive disorder surgeries.
“The most common cause of GERD is the weakening of the lower esophageal sphincter (LES), a circular bundle of muscles that controls the flow of food and liquid from your esophagus into your stomach. If it doesn’t close completely after food passes, stomach acid will flow back up into your esophagus,” says Dr. Iqbal.
There are two surgery options to strengthen the LES. Nissen Fundoplication is the gold standard for treatment of severe GERD and hiatal hernia. The laparoscopic procedure involves wrapping the upper part of the stomach around the lower portion of the esophagus and stitching it in place to reinforce the weakened LES. Dr. Iqbal has performed over 5,000 of these procedures.
A second, less invasive surgery, is called the LINX procedure and involves the implantation of the LINX device, a small, flexible ring of titanium beads with magnetic centers. When the ring is wrapped around the weak LES, the magnetic attraction causes it to contract, helping the LES stay closed.
Due to the severity and size of Terri’s hiatal hernia, Dr. Iqbal recommended Nissen Fundoplication. Six weeks after surgery, Terri was able to return to work and caring for patients – GERD-free.
For more information, or to schedule an appointment at the Digestive Care Center at Orange Coast Medical Center, visit memorialcare.org/ocdigestivecare or call (714) 378-7664.
For more information about treatment of GERD, visit memorialcare.org/gerd or listen to Dr. Iqbal’s podcast by clicking here.