{"id":5465,"date":"2019-11-03T22:31:16","date_gmt":"2019-11-03T22:31:16","guid":{"rendered":"https:\/\/www.institutoendoscopiaavanzada.com\/2019\/11\/03\/enfermedad-por-reflujo-gastroesofagico\/"},"modified":"2023-11-07T16:41:21","modified_gmt":"2023-11-07T16:41:21","slug":"enfermedad-por-reflujo-gastroesofagico","status":"publish","type":"post","link":"https:\/\/www.institutoendoscopiaavanzada.com\/en\/enfermedad-por-reflujo-gastroesofagico\/","title":{"rendered":"Gastroesophageal reflux disease"},"content":{"rendered":"<div class=\"lRu31\"><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">In a <strong>hiatus hernia<\/strong>, part of the stomach lodges in the chest cavity, instead of being confined to the abdomen, as is usual.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">This situation can be the cause of GERD.<\/span><\/span> <\/span><\/div>\n<div><\/div>\n<div class=\"lRu31\"><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">The treatment of the most common hiatal hernia, known as axial or sliding hernia, when it measures more than 3cm, is through a laparoscopic surgery technique known as Nissen Fundoplication.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">It is a relatively non-aggressive surgical technique with good medium-term results.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">When the hiatus hernia is small in size, when it measures 3 centimeters or less, it can be treated endoscopically using a technique known as MUSE (Medigus Ultrasonic Surgical Endostapler), which consists of trapping the herniated stomach towards the chest using an endoscopic suture.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">back to the abdominal cavity, without the need for surgery.<\/span><\/span><\/span><\/div>\n<div id=\"ow6276\"><\/div>\n<div class=\"UdTY9 WdefRb\" aria-hidden=\"true\" data-location=\"2\">\n<div class=\"kO6q6e\"><\/div>\n<\/div>\n<p><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">However, a very common cause of GERD, with few treatment options until now, has been what is known as Cardias Incompetence.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">The cardia is a valve-like anatomical structure that allows food to pass from the esophagus to the stomach, and limits the passage of gastric contents to the esophagus.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">In the situation known as Cardias Incompetence, this structure is permanently open, allowing gastric contents to reflux freely into the esophagus.<\/span><\/span><\/span><\/p>\n<p><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">Through the plastic endoscopy technique known as Antireflux Mucosectomy, ARMS, we can modify the dysfunctional shape of the cardia so that it fulfills its anatomical mission and makes it difficult for the acid content of the stomach to pass into the esophagus.<\/span><\/span><\/span><\/p>\n<p><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">The ARMS technique, unlike fundoplication, does not alter the gastric anatomy, it only closes the junction between the esophagus and stomach that is abnormally open, causing reflux.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">It is a procedure that only affects the most superficial layers of the stomach and only requires hospital admission for 24 hours.<\/span><\/span><\/span><\/p>\n<p><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">How it is performed: through the mouth in the operating room and under orotracheal intubation, a gastroscope with a special rigid plastic cap at the tip is introduced.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">The respectful mucosal area is marked with a scalpel.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">Subsequently, physiological saline dyed with indigo carmine is infiltrated into the submucosal layer (as identification).<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">After this, a special polypectomy loop, asymmetrical and more flexible than usual, is loaded into the cap.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">The immediately subcardial area is confronted, the mucosa is aspirated inside the cap and cut to the muscle with the loop.<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">This entire process is repeated approximately 5-6 times, to cover 90% of the gastric circumference.<\/span><\/span><\/span><\/p>\n<p><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">It is performed in the operating room and under orotracheal intubation and lasts approximately 60 minutes, with expected discharge in less than 48 hours.<\/span><\/span><\/span><\/p>\n<p><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">Recovery after the technique is also much faster, and with fewer symptoms.<\/span><\/span><\/span><\/p>\n<p><span class=\"HwtZe\" lang=\"en\"><span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">The Advanced Interventional Endoscopy Unit of the Quir\u00f3nSalud Hospital in M\u00e1laga is a pioneer in the endoscopic treatment of Reflux disease, being one of the few centers in Spain accredited for the endoscopic treatment of hiatal hernia using the MUSE technique, as well as the only center<\/span><\/span> <span class=\"jCAhz ChMk0b\"><span class=\"ryNqvb\">European, public or private, in which the ARMS technique is carried out with excellent results.<\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In a hiatus hernia, part of the stomach lodges in the chest cavity, instead of being confined to the abdomen, as is usual. This situation can be the cause of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[25,23],"tags":[],"class_list":["post-5465","post","type-post","status-publish","format-standard","hentry","category-diseases","category-open-classes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Gastroesophageal reflux disease - Instituto de Endoscopia Digestiva Avanzada<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.institutoendoscopiaavanzada.com\/enfermedad-por-reflujo-gastroesofagico\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gastroesophageal reflux disease - Instituto de Endoscopia Digestiva Avanzada\" \/>\n<meta property=\"og:description\" content=\"In a hiatus hernia, part of the stomach lodges in the chest cavity, instead of being confined to the abdomen, as is usual. 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