Acid reflux is exceptionally common, with some estimates suggesting it affects more than 60 million people in the United States every month. Sometimes acid reflux becomes more than an uncomfortable nuisance, turning into a larger health issue that can even end up affecting the physical structure of your esophagus and stomach. When heartburn and reflux become serious enough that it affects your quality of life, the Heartburn & Reflux Center of Door County is here for you.
For Jon Hurley, heartburn and acid reflux symptoms started nearly 20 years ago. "It started as occasional heartburn that I would take antacids for," Jon recalls. "But as the years went by," he continues, "the heartburn became more frequent and with much stronger symptoms."
Eventually, Jon began experiencing acid reflux several times a week, at any point during the day, and it was becoming more frequent and intense at night. "I was having reflux more nights than not," he remarks, adding, "Sometimes, the acid reflux and regurgitation would get so bad that it would wake me up for several hours, and at that point, prescription medications were only occasionally effective."
Acid reflux generally occurs when the lower esophageal sphincter (LES)—a circular muscle that connects the esophagus and stomach and that tightens after food passes into the stomach—becomes weak and allows the stomach acid that digests your food to flow backwards into the esophagus. When acid reflux becomes a serious and chronic problem, it is referred to as gastroesophageal reflux disease, or GERD.
Finding a more permanent solution
A few years ago, Jon saw his primary care physician at Door County Medical Center about his condition, and Dr. Richard Hogan diagnosed a hiatal hernia. A hiatal hernia occurs when the upper portion of the stomach bulges through an opening in the diaphragm, thereby reducing pressure on the LES and allowing stomach acid to leak through into the esophagus. In other words, the symptoms of GERD Jon had experienced for years—the chronic acid reflux and regurgitation—originated with the hiatal hernia. Indeed, GERD is one of the primary conditions associated with a hiatal hernia.
As those symptoms became increasingly unmanageable through over-the-counter medications, and because of mounting concerns regarding the long-term health implications of an untreated hiatal hernia and untreated GERD, Jon made the decision to find a more permanent solution. "I sought out treatment for two reasons," Jon says. "Primarily, I was concerned that if I didn't get the hiatal hernia and LES fixed, the damage to my esophagus—the esophageal erosion and inflammation caused by continuous acid reflux—could develop into a more serious condition called Barrett's esophagus, which could then lead to cancer. Also," Jon continues, "I had been taking acid reflux medications—proton pump inhibitors—for more than 20 years. Long-term use of these medications is associated with serious side effects like kidney disease and dementia."
The decision to get surgery
"I was born in Sturgeon Bay, and have spent most of my adult life here," Jon says, adding, "Most of the healthcare I have received in my life has been through Door County Medical Center, and I've always had great prior experiences. My wife, Kerry, has been a nurse at DCMC for 17 years," he continues, "and she was very trusting of the excellent care I would receive both during my surgery and during recovery. So, the decision to go to Door County Medical Center to address my hiatal hernia and GERD was easy."
"Both Kerry and Dr. Hogan recommended that I see Dr. St. Jean," Jon recalls. Dr. Michael St. Jean specializes in minimally invasive surgery and has extensive experience using the da Vinci Xi surgical robot to address conditions like Jon's. "Once I met with Dr. St. Jean," Jon says, "and we discussed the procedure he would be performing, I decided this was the best chance for me to cure my acid reflux and to stop taking the daily prescription medications that were failing to do the job."
Surgery, and the road to recovery
Prior to surgery, Jon underwent several studies to confirm the hiatal hernia and dysfunctional LES that both Dr. Hogan and Dr. St. Jean suspected. He received an esophagram—a type of x-ray that assists in exploring the anatomy of the esophagus and stomach, and that can also be used to establish whether a hiatal hernia is present and to help determine its size; the BravoTM reflux test—a minimally invasive test that places a small capsule on the esophageal wall and monitors pH levels for 48 hours to assess whether acid from the stomach is moving past the LES and into the esophagus; and Dr. St. Jean performed an upper gastrointestinal endoscopy, which involves a thin, lighted tube with a small camera on the end being inserted into the esophagus (via the mouth), allowing the doctor to look at the inside of your esophagus, stomach, and the first part of your small intestine.
Once the hiatal hernia and the dysfunctional LES were confirmed, the decision was made to perform a Nissen Fundoplication. This surgical procedure involves repairing the hiatal hernia and the opening in the diaphragm with stitches or mesh, then attaching the uppermost part of the stomach (the fundus) to the lower esophageal sphincter in order to increase pressure on that muscle and restore the natural, physiological anatomy of the LES. It is a laparoscopic, minimally invasive procedure that is performed with the assistance of the da Vinci Xi surgical robot, and results in minimal side effects, eliminating the need for long-term medical therapy.
"Everything went as planned," Jon remarks, adding, "There were no surprises during the preparation and evaluation, and afterwards they confirmed that both the Nissen Fundoplication procedure and the hiatal hernia fix were both successful. " Following my discharge," Jon continues, "I was on a progressive diet so my stomach and esophagus could begin healing—a couple weeks of liquids only, then onto a soft foods diet. Healing from the surgical procedure did take some time, but I was in no hurry to rush that process."
"Today," Jon says, "I'm feeling close to 100%, and I'm no longer taking any medication for acid reflux. At 6 months," he continues, "I had a check up that confirmed that my LES and stomach are functioning normally. And while I've had to make some changes to my eating habits and diet, I'm happy to report that I received the results I was hoping for—I am healthier today than before my surgery."
Don't let recurring heartburn go unchecked, recurring and chronic heartburn and reflux can lead to more serious health issues down the road. If you, or someone you know, is experiencing heartburn on a regular basis, or the symptoms of heartburn have begun to impact quality of life, contact Door County Medical Center's Heartburn & Reflux Center at: 920-746-1060. For more information on the different options for treatment the Heartburn & Reflux Center offers please visit our website at: https://www.dcmedical.org/medical-services/heartburn-reflux-center-of-door-county.