Shortterm symptomatic and pH results are consistently improved by surgery.Ī prospective study was conducted to evaluate the physiologic and clinical consequences of laparoscopic Nissen fundoplication (LNF), using strict indications for surgery.įrom 1992 to 1997, 50 patients underwent LNF. With experience, the duration of operation falls and the hospital stay is shorter. Laparoscopic Nissen fundoplication is a safe and effective procedure for gastro-oesophageal reflux disease. Median total symptom scores fell from 5/9 to 0/9 after fundoplication (< 0.0001) while median 24 hour oesophageal acid exposure in 96 patients was reduced from 10% to 1% (p < 0.001). This compared with a median operation time of 120 minutes (60-240) (p = 0.0003, 95% CI 10, 40), a conversion rate of 2% (p = 0.2), a hospital stay of three days (1-18) (p = 0.0016, 95% CI 0, 1), and total morbidity of 7% (p = 0.15) in the second 100 patients. In the first 100 patients median duration of operation was 155 minutes (range: 70-330), conversion rate to laparotomy was 7%, median hospital stay was three days (range: 2-57), and total morbidity was 16%. Patients were evaluated at three and 12 months after surgery with symptom scoring and 96 patients also underwent 24 hour pH studies at three to six months postoperatively. Pre-operative assessment included symptom score, endoscopy, manometry, and 24 hour pH monitoring of the oesophagus. If lifestyle changes fail to control symptoms, then medicines can be added.Laparoscopic Nissen fundoplication was undertaken in 200 patients between 19. Safely raising the head of your bed by about 20cm with something strong such as a piece of wood or wooden blocks, or using a pillow to wedge the mattress, can help if you have reflux symptoms at night. Cutting back can relieve symptoms in some people. Cut back on alcoholĪlcohol irritates the stomach and relaxes the muscles around the oesophagus, allowing stomach acid to reflux. ExerciseĮxercising regularly, such as walking every day, can help with digestion and weight loss. Ask your doctor whether you need to lose weight. The more weight you lose, the greater the relief. Lose weightįor people who are overweight or obese, losing just a few kilos can significantly reduce the risk of having frequent symptoms. Quitting smoking has been shown to significantly improve symptoms in people who are taking medication for GORD. Tobacco smoke irritates your digestive system and makes your symptoms worse. Drink plenty of fluids such as water, but avoid or cut down on soft drinks and caffeinated drinks. To improve your digestion, it’s a good idea to increase fibre by replacing some of your normal diet with wholemeal bread, brown rice, fruit and vegetables, beans and oats. Try to make mealtimes stress-free by eating slowly, taking time to chew food properly and generally making sure it is a relaxing time.
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