Transcription:

Prakash Chandran (Host): If your heartburn isn’t going away and medicine just isn’t cutting it; it might be time to look at other options including surgical treatment. Let’s talk about it with Dr. George Rossidis, a surgeon at Ocala Health Surgical Group. This is Helmet of Health, the podcast from Ocala Health. I’m Prakash Chandran and Dr. Rossidis, can you tell us what causes heartburn in the first place?

George Rossidis, MD (Guest): Good morning. It’s a great pleasure talking to you. So, what causes heartburn is a very, very simple mechanism. We all know that we need a lot of acid in order to be able to breakdown the food that we ingest. The acid is produced in the stomach and the acid has no place in the esophagus which is the tube that leads the food from the mouth to the stomach. Usually, we have a valve that prevents that reflux of the gastric acid and contents into the esophagus. If we have a malfunctioning or weak valve, what we call the lower esophageal sphincter; that allows the gastric contents and specifically acid to reach into the esophagus which causes the symptoms and effects of heartburn and gastroesophageal reflux.

Host: I think we’ve all experienced that heartburn. It’s that pain especially when we swallow things and I’m definitely used to when that happening I take Rolaids, Pepto Bismol, things of that nature. Is that typically what people go to when they have heartburn?

Dr. Rossidis: Yes, Rolaids and Pepto Bismol are pretty much the first line of defense. Because what they do if you think about it, these Rolaids and Pepto Bismol have basic substances that are basically inclined to eliminate the acid and that’s how they work. If that doesn’t work; then the most common thing after that, the second line is a medication that stops the acid production what we call the acid blockers whether it’s H2 blockers or the so-called proton pump inhibitors.

Host: And that is something that’s prescribed by a doctor, let’s say I’m having severe heartburn, I’ll go to a doctor and I’ll say you know what, this Pepto Bismol isn’t working. You’ll give me the acid blockers, right?

Dr. Rossidis: That is usually the case, yes.

Host: And just out of curiosity, how common is heartburn? Does everyone experience it? Like what do we do to bring it on to ourselves?

Dr. Rossidis: Heartburn is actually a very common entity in the US population. We know that 20% or one in five patients in the Untied States do suffer from heartburn. And we have what is known 20 million patients that are on the acid blockers, 20 million. So, the annual cost associated with reflux amounts to six billion dollars a year. So, yes, it’s a very – there’s a very high prevalence of reflux in the United States.

Host: Wow that is so much bigger than I thought. So, let’s say that I go, I take the Rolaids, that’s not working, the acid blockers aren’t working; I’ve also heard of these surgical treatment options. Maybe you can talk a little bit about that.

Dr. Rossidis: Yes, we have options for either patients that are not responding to the medications and we know that of those 20 million patients that are on acid blockers; around 40% of them still have symptoms, or patients that do not want to be on a medication for the rest of their life; we have options that are able to eliminate the need for any medications and also eliminate all the symptoms associated.

So, all of the different surgical options that we have, out intent is to reinforce that weak valve that we mentioned earlier. And so, how do we address that? We can either do procedures that wrap the stomach around the esophagus causing basically a one way valve where they allow food to come down, but no acid would be regurgitated into the esophagus or the latest and greatest, is a string of beads where we have magnets. It’s a small bracelet that we place around the distal esophagus and that bracelet constricts and reinforces that valve that we have between the esophagus and the stomach and opens up when food comes down into the stomach but then closes and prevents the acid from the stomach to reach into the esophagus.

All of the procedures are done in a laparoscopic fashion which means it’s done minimally invasive procedure and the recuperation is excellent where the patients either go home the same day or they stay in the hospital only for a period of one night.

Host: That’s great to know that there’s so many different options to completely remove heartburn if it gets bad for any of us. So, I really appreciate your time Dr. Rossidis. That’s Dr. George Rossidis, a surgeon at Ocala Health Surgical Group.

Thanks for checking out this episode of Helmet of Health and head to www.ocalahealthsystem.com to get connected with a provider. If you found this podcast helpful, please share it on your social channels. That would really help us out. And be sure to check out the entire podcast library of topics of interest to you. Thanks and we’ll see you next time.