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Tuesday, April 30, 2024

Gallbladder and Reflux Disease


Special to 318 Forum

With May being Women’s Health Month, CHRISTUS Trinity Clinic focuses on some medical issues prevalent among women and the available treatment options.

Dr. George Merriman, a general/bariatric surgeon with CHRISTUS Trinity Clinic, addresses two of those medical concerns: gallbladder disease and reflux disease.

“There is a genetic component to gallbladder disease,” Merriman said. “It occurs more commonly in middle-aged women, which shows it has a genetic component to it.”

Gallbladder disease symptoms include pain in the upper right abdomen.

“Your gallbladder is a small pear-shaped organ that holds this digestive juice called bile,” he said. “As long as it’s flowing constantly and consistently, it’s fine. But if it becomes stagnant, crystals form in the fluids and those crystals form what we call stones. It happens more frequently in women as they age.”

Merriman said fatty foods stimulate the gallbladder the most.

“So, you can modify your diet,” he said. “The risks of having complications from known gallstone formation are higher than the risks of an elective, straightforward surgery.”

Merriman said severe complications can arise if the gallstones move out of the gallbladder and into the main system.

“It can cause all kinds of things, including pancreatitis and all the issues that flow from that,” he said. “Pancreatitis is a much more severe disease to be dealing with.”

Gallbladder disease is easy to diagnose, according to Merriman.

“In this day and age, it’s so straightforward to ultrasound the abdomen in that area. It’s more difficult when the patient has the symptoms but hasn’t actually formed gallstones yet,” he said.

“We have technology where we can measure the level of function of the gallbladder when it squeezes to empty that bile liquid into the main system.”

If the gallbladder needs to be removed, Merriman said laparoscopic surgery is performed.

“You have surgical instruments that you place through really small incisions in the skin, which are 5 to 10 millimeters,” he said. “You put a tube through that hole in the skin all the way through the abdominal wall into the abdominal cavity and fill the abdominal cavity with gas that distends the abdominal cavity.”

With laparoscopic surgery, Merriman said recovery time is faster, and there is less risk of infection.

“Laparoscopic surgery has been the biggest benefit for women, moms especially,” he said. “To have gallbladder surgery and be able to be mom again functionally in a few days to a week versus six weeks, that’s a big deal.”

Merriman said he is an expert when it comes to reflux surgery.

“We now refer to it as foregut surgery, which focuses on the esophagus and the stomach,” he said. “Reflux is a dysfunction of basically the esophagus and the stomach, for the most part, and the first part of the small intestine as you go down the chain.”

Merriman added, “Most people think simplistically about the process that results in gastroesophageal reflux or heartburn, which is the key symptom, a sense of discomfort in the esophagus, an acid kind of taste in the back of your mouth. Reflux surgery is the definitive treatment of the problem.”

Merriman said the risk of esophageal cancer grows with uncontrolled reflux.

“Even though esophageal cancer is uncommon, it’s very difficult to treat,” he said.

However, Merriman said the LINX device is a very effective form of treatment.

LINX Reflux Management System is a revolutionary medical implant designed to enhance the function of the lower esophageal sphincter and prevent stomach acid from flowing back into the esophagus and throat. It consists of a small, flexible ring made of magnets placed around the outside of the esophagus through a minimally invasive laparoscopic procedure.

“One of the reasons I’ve become such a fan of the LINX device is because it’s simple and effective. It’s never going to weaken, and it’s never going to diminish,” Merriman said. “It’s always going to be there, and it’s always going to work.”

Merriman said not everyone is a candidate for anti-reflux surgeries.

“Some people have bad heartburn, not because they’re having bad reflux. It’s because their esophagus doesn’t function normally,” he said. “It doesn’t push hard enough to push the juice down into the esophagus. For somebody that has bad reflux, even if their symptoms are controlled with medications, I would strongly encourage them to get evaluated by a surgeon.”

To learn more about CHRISTUS Trinity Clinic, visit CHRISTUSHealth.org.


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