GERD Treatment in Raipur

Gastroesophageal reflux disease (GERD) or chronic acid reflux occurs when stomach acid repeatedly flows back into the oesophagus, irritating and damaging its lining. GERD is diagnosed when reflux symptoms occur two or more times per week or when endoscopic damage is present regardless of symptom frequency. At Ramkrishna CARE Hospitals, Raipur GERD is managed through a structured pathway from lifestyle modification to laparoscopic anti-reflux surgery.

Symptoms of Gastroesophageal Reflux Disease

GERD produces oesophageal and extra oesophageal symptoms:

• Heartburn (pyrosis): Burning from the upper abdomen toward the chest or throat that worsens after meals, on lying down or bending forward
• Acid regurgitation: Effortless return of sour acid or food into the mouth or throat without vomiting
• Dysphagia (difficulty swallowing): Feeling of food sticking in the chest indicates oesophageal inflammation or a peptic stricture (narrowing from chronic acid scarring)
• Odynophagia: Painful swallowing suggests oesophageal ulceration
• Chronic cough: Persistent dry cough, especially at night from micro-aspiration of acid into the airways or vagal nerve stimulation
• Hoarseness and laryngitis: Acid reaching the larynx damages the vocal cords; voice is rough or strained, especially in the morning
• Globus sensation: A persistent feeling of a lump in the throat that does not go away with swallowing
• Non-cardiac chest pain: GERD mimics cardiac angina pain
• Dental erosion: Chronic acid dissolves tooth enamel causing sensitivity and visible surface loss.

Causes of GERD

GERD results from failure of the anti-reflux barrier at the gastro-oesophageal junction. It results from:

• LOS dysfunction: When the lower oesophageal sphincter (LOS) is weakened or fails, acid, bile, and pepsin flow upward into the oesophagus, which lacks the stomach's protective lining causing GERD. 
• Hiatus hernia: Part of the stomach pushes through the diaphragm resulting in a hiatus hernia. This disrupts the angle of His, impairs LOS function, and creates an acid reservoir above the diaphragm
• Obesity: The most important modifiable risk factor for GERD
• Delayed gastric emptying: From diabetes, hypothyroidism or medication
• Pregnancy: Rising progesterone relaxes the LOS and the enlarging uterus raises intra-abdominal pressure
• Dietary triggers: Large meals, eating just before lying down, carbonated drinks, spicy food, citrus, alcohol and tobacco

GERD Diagnosis

Diagnosis combines clinical assessment with objective tests:

• GerdQ symptom score: Questionnaire designed to diagnose GERD; 8 or above has a higher sensitivity for GERD
• Upper GI endoscopy: Identifies oesophagitis, peptic stricture, Barrett's oesophagus and hiatus hernia. Doctors suggest a biopsy if Barrett's or malignancy suspected
• 24-hour pH monitoring: Measures oesophageal acid exposure and is the gold standard for confirming pathological acid reflux
• High-resolution manometry: Measures LOS pressure and oesophageal peristalsis; mandatory before surgery to confirm LOS dysfunction and ensure motility is adequate for fundoplication
• Barium swallow: Identifies hiatus hernia, stricture, and reflux and is usually used when endoscopy is not possible.

Risk of GERD

Several factors significantly raise GERD risk.

• Obesity: BMI above 30 doubles GERD risk and raises intra-gastric pressure
• Age: With age LOS pressure declines, which increases the risk of GERD
• Tobacco and alcohol: Both reduce LOS pressure and delay gastric emptying
• Medications: Calcium channel blockers, nitrates, NSAIDs, and bisphosphonates all worsen GERD
• Family history: genetic factors influence LOS competence and Barrett's risk

Complications of GERD

Poorly controlled GERD progressively damages the oesophagus and causes the following:

• Erosive oesophagitis 
• Peptic stricture & progressive dysphagia
• Barrett's oesophagus 
• Oesophageal adenocarcinoma risk
• Aspiration pneumonia 
• ENT and dental complications like laryngitis, vocal cord damage, sinusitis, and tooth erosion from laryngopharyngeal reflux.

GERD Treatment Options

Treatment follows a stepwise approach, including lifestyle first, then medication, then surgery:

• Lifestyle Modification: Helps improve mild GERD:
  • Weight loss of 5 to 10%
  • Head-of-bed elevation by 15 to 20 cm
  • Avoiding triggers
  • No food within 3 hours of lying down
  • Stopping smoking
  • Reducing alcohol.
• Medical Treatment
  • PPIs reduce gastric acid and heal Grade A and B oesophagitis 
  • H2-receptor antagonists provide milder suppression for mild symptoms. 
  • Alginate preparations form a physical raft above gastric contents. 
  • Prokinetics improve gastric emptying as adjuncts.
• Endoscopic Treatment
  • Transoral incisionless fundoplication (TIF) reconstructs the gastro-oesophageal valve endoscopically. 
  • Radiofrequency ablation improves LOS competence. 
• Surgical Treatment
  • Laparoscopic Nissen fundoplication (LNF): LNF is the gold standard for GERD. In this procedure, the gastric fundus wraps 360 degrees around the lower oesophagus, recreating the LOS and restoring the angle of His and hiatal crura are repaired simultaneously. Toupet fundoplication (270-degree wrap) is used for impaired peristalsis.

What is the Procedure of GERD Treatment?

The procedure follows a structured, evidence based sequence:

• Consultation and tests: Doctors take your clinical history and perform symptom scoring and upper GI endoscopy with biopsy (where indicated). High resolution manometry and 24 hour pH monitoring confirm pathological reflux and LOS dysfunction before surgery.
• Pre operative optimisation: PPIs are continued up until the day of surgery. Patients are strongly advised to lose weight and stop smoking ahead of the procedure. Anaesthesia assessment & routine blood tests are completed during this phase.
• Laparoscopic Nissen fundoplication: The surgeon makes five small incisions in the abdomen and uses a camera to visualise the gastro-oesophageal junction. The crura are repaired and a 52 to 56 French bougie is passed to calibrate the wrap. The fundus of the stomach is then wrapped 360 degrees around the lower oesophagus and sutured into position. The procedure typically takes between 60 and 90 minutes.
• Hospital recovery: Clear fluids are introduced within 4 to 6 hours of surgery. Most patients are discharged the following morning and remain on a liquid and soft diet for 2 to 4 weeks. Mild difficulty swallowing is common in the first 2 to 6 weeks and resolves as post-operative swelling settles.
• Follow-up: Review appointments are scheduled at 2 to 4 weeks and again at 3 months. PPIs are discontinued once successful reflux control is confirmed. 

Benefits of GERD Treatment

Effective GERD treatment produces benefits that extend beyond symptom relief:

• Heartburn and regurgitation eliminated 
• Acid control reduces Barrett's progression to adenocarcinoma
• Extra-oesophageal symptoms like chronic cough, hoarseness and laryngitis resolve with effective control
• Reduced PPI dependence after surgery
• Oesophagitis healing reduces pain, bleeding, and stricture risk
• Improvements in sleep, dietary freedom and daily activity.

Why Choose Ramkrishna CARE Hospitals for GERD Treatment in Raipur?

Ramkrishna CARE Hospitals, Raipur, provides comprehensive GERD care ranging from endoscopic assessment and pH monitoring through to laparoscopic anti-reflux surgery. Gastroenterology and surgical teams work together to tailor a treatment plan. High-resolution manometry, 24-hour pH monitoring, and upper GI endoscopy with biopsy are all available under one roof without referral elsewhere.

Patients choose us for experienced surgeons performing Nissen and Toupet fundoplication regularly, modern laparoscopic theatres, a private endoscopy suite, cashless insurance support and structured post-operative follow-up.