**Gastroesophageal Reflux Disease (GERD)** is a common condition where stomach acid frequently flows back into the esophagus, causing bothersome symptoms like heartburn, regurgitation, and sometimes damage to the esophageal lining. While lifestyle changes and medications (like PPIs) are the first line of treatment, some individuals may not respond adequately, or prefer an alternative to long-term medication use. For such cases, **anti-reflux procedures** offer effective, minimally invasive solutions to restore the natural anti-reflux barrier. Dr. Neeraj Dhar provides comprehensive evaluation and advanced endoscopic anti-reflux therapies in Faridabad.

Understanding GERD and When Procedures Are Needed:

GERD occurs when the **lower esophageal sphincter (LES)**, a muscular valve at the junction of the esophagus and stomach, weakens or relaxes inappropriately, allowing stomach contents to reflux. When GERD is chronic, severe, or causes complications like esophagitis, strictures, or Barrett's esophagus, and conservative treatments are insufficient, anti-reflux procedures may be considered.

Indications for Anti-Reflux Procedures:

• Chronic GERD symptoms (heartburn, regurgitation) unresponsive to maximum medical therapy (e.g., high-dose PPIs).
• Desire to discontinue long-term PPI therapy due to concerns about side effects or inconvenience.
• Presence of GERD complications, such as esophagitis or strictures, despite medication.
• Patients with atypical GERD symptoms (e.g., chronic cough, hoarseness, asthma) confirmed to be due to reflux.
• Evidence of a weak or dysfunctional LES based on diagnostic tests.

Types of Anti-Reflux Procedures (Focus on Endoscopic):

While surgical fundoplication (e.g., Nissen fundoplication) remains an option, endoscopic anti-reflux procedures are minimally invasive alternatives performed by gastroenterologists like Dr. Neeraj Dhar:

1. Transoral Incisionless Fundoplication (TIF) using EsophyX:

• This procedure reconstructs the anti-reflux barrier from within the stomach without external incisions.
• A specialized device (EsophyX) is passed through the mouth over an endoscope.
• It allows Dr. Dhar to grasp and fold stomach tissue around the lower esophagus, creating a partial fundoplication (a new valve-like structure).
• Fasteners are deployed to secure this wrap, effectively tightening the LES and restoring its barrier function.

2. Anti-Reflux Mucosectomy (ARMS) / Endoscopic Full-Thickness Plication (EFTP):

• **ARMS:** Involves removing a small, specific portion of the esophageal lining (mucosa) just above the gastroesophageal junction. As this area heals, it contracts and creates fibrosis, tightening the opening and reducing reflux.
• **EFTP:** A newer technique involving full-thickness plication (folding and suturing) of the gastroesophageal junction using endoscopic suturing devices to create a more robust anti-reflux barrier.

(Note: The specific endoscopic procedure offered may vary based on patient suitability and the gastroenterologist's specialized expertise and available technology.)

Benefits of Endoscopic Anti-Reflux Procedures:

• **Minimally Invasive:** No external incisions, leading to less pain, faster recovery, and no visible scars.
• **Outpatient/Short Hospital Stay:** Many procedures can be performed on an outpatient basis or with a short overnight stay.
• **Reduced Risk:** Generally lower risk of complications compared to traditional open or laparoscopic surgery.
• **Improved Symptoms:** Significant reduction or elimination of GERD symptoms for many patients.
• **Potential for PPI Discontinuation:** Many patients can reduce or stop their daily PPI medication.

Preparation for the Procedure:

A thorough evaluation is critical to determine the best anti-reflux procedure for you:

• Diagnostic Tests: This typically includes a detailed upper endoscopy, 24-hour pH monitoring (to measure acid exposure), and esophageal manometry (to assess muscle function and rule out other conditions).
• Fasting: You will need to fast for at least 6-8 hours before the procedure.
• Medication Review: Discuss all current medications with Dr. Dhar, especially blood thinners, as adjustments may be necessary.
• Arranging for Support: You will need someone to drive you home after the procedure.

What to Expect During the Procedure:

• The procedure is performed under **general anesthesia**, ensuring you are comfortably asleep.
• Dr. Dhar will use an endoscope equipped with specialized instruments to perform the chosen anti-reflux procedure.
• The procedure duration varies depending on the technique but typically ranges from 60 to 90 minutes.

Recovery and Post-Procedure Care:

• You will be monitored in a recovery area until the effects of anesthesia wear off.
• You may experience some mild chest discomfort, sore throat, or difficulty swallowing for a few days, which is usually manageable with pain medication.
• A gradual progression of diet, starting with liquids and slowly advancing to soft foods, will be recommended for several weeks.
• Detailed instructions on post-procedure care, dietary modifications, and follow-up appointments will be provided.
• Long-term follow-up with Dr. Dhar is essential to monitor symptom control and overall success of the procedure.

Why Choose Dr. Neeraj Dhar for Anti-Reflux Procedures?

Dr. Neeraj Dhar is a highly skilled and experienced gastroenterologist in Faridabad, specializing in advanced endoscopic therapies for gastrointestinal conditions, including GERD. His expertise in diagnostic procedures (pHmetry, manometry) and precise execution of endoscopic anti-reflux techniques like TIF or ARMS ensures accurate patient selection and optimal outcomes. Dr. Dhar is dedicated to providing personalized care, thoroughly evaluating each patient's condition to recommend the most suitable and effective anti-reflux solution, helping them achieve lasting relief from GERD symptoms and improve their quality of life.

If you are struggling with chronic GERD symptoms and are seeking advanced, minimally invasive treatment options, consult Dr. Neeraj Dhar for expert evaluation and care in Faridabad.