Acid Reflux: When Surgery Is the Fix

Sept. 19, 2006 — -- Food is almost an essential part of Bill Levine's life -- he works in the gourmet food business.

About five years ago, food began to cause Levine a little trouble. He noticed food would often get stuck in his throat, causing him pain and making him cough. The worst episode occurred while he was eating spareribs with his family.

"In front of everybody it got stuck," Levine said.

He grabbed a glass of water in an attempt to wash the ribs down, but instead he spat both the ribs and the water all over the table. His family watched the whole thing.

"They got so scared," Levine said.

Despite those fears, Levine didn't believe anything medically wrong had caused the incident, so he didn't do anything about it. "I figured it was because I was eating too fast, or it was a tough piece of steak or chicken," he said.

When Levine finally went to the doctor, he learned that the problem was not that he was eating too fast or trying to swallow a tough piece of steak -- it was acid reflux, caused by a large hole in his diaphragm. And some of his stomach was actually poking through that hole into his chest, a condition known as hiatal hernia.

Hiatal hernias are very common, but their cause is unknown. They are often linked to cases of acid reflux, in which digestive acids from the stomach flow back into the esophagus.

Levine's hernia was serious enough to require surgery.

By the time he had it repaired, more than half of his stomach had been pushed up by his heart and lungs. This was causing stomach acid to back up into his esophagus, or food pipe.

"The constant flow of acid up into his chest starts to affect the esophagus, and it can really cause ongoing problems with swallowing," said Dr. George Fielding, a surgeon at New York University Medical Center.

Fielding brought Levine into the operating room and pulled Levine's stomach out from his chest and back into his abdomen where it belongs.

Fielding then repaired the hole in the diaphragm. To make sure the acid reflux wouldn't happen again, he wrapped the top of the stomach around the bottom of the esophagus.