Aftercare

The inability to work is usually 4-7 days (office work). However, physical work is forbidden for at least 6-8 weeks and lifting of loads over 5-7 kg should be avoided during this time. Extreme sports (martial arts, skydiving, extreme climbing, etc.) should also be avoided for three to six months. Food intake is possible immediately. During the first 2-7 days (depending on the procedure) only pureed food is allowed. After that, we recommend eating several small meals a day for another two to three weeks. After that, a rapid return to normal food intake is made.

In case of severe esophagitis, an esophagoscopy and gastroscopy should be performed 6-12 months after surgery to monitor the progress.

Conclusions

Reflux disease is the most common benign disease of the upper gastrointestinal tract in the Western world. 10-25% of the population suffers from it permanently(!).

Acute therapy is always conservative (dietary changes, raising the head of the bed, weight reduction, etc.). In most cases, medium-term drug treatment is unavoidable. After discontinuation of the medication, unfortunately, more than half of the patients experience a recurrence of the symptoms. In this case, there is an alternative between long-term drug therapy using proton pump inhibitors and surgical antireflux therapy, which is performed laparoscopically (minimally invasive).

Regarding the results, minimally invasive antireflux surgery seems to be permanently superior to conservative long-term drug therapy. In the hands of an experienced antireflux surgeon, the long-term success rate is nowadays about 85-95%.

Surgical treatment of reflux disease is still not very widespread and the indication for surgery is only hesitantly made (especially by gastroenterologists), certainly also because drug therapy with proton pump inhibitors very successfully combats the symptoms of reflux disease. In recent years, however, there have been increasing warnings in various media of the possible not inconsiderable long-term side effects of taking proton pump inhibitors. The results of large-scale studies remain to be seen before more precise recommendations can be made.  However, modern minimally invasive surgical procedures provide highly reliable, gentle, less stressful and, above all, durable alternatives to long-term drug therapy. In our opinion, surgical (causal!) therapy for reflux disease should be increasingly integrated into the shortlist of treatments.