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Published on January 10, 2019

After 30 Years of Heartburn, Local Man Finally Finds Relief

“I would have heartburn after every single meal,” says Robert Katcher, a 67-year-old of Peotone. “It was especially painful after eating spicy or tomato-based foods, such as salsa or pasta with marinara. During the night, I would wake up with my chest feeling like it was on fire.”

The heartburn Robert describes plagued him for more than 30 years. It wasn’t until March 2018 that he found relief, thanks to a robotic-assisted surgery at Palos Hospital.

Dealing with GERD

Long before his surgery, Robert’s primary care physician referred him to a gastroenterologist, who diagnosed him with gastroesophageal reflux disease (GERD), a common condition that occurs when food and stomach acid back up into the esophagus. The gastroenterologist prescribed him acid-blocking medication and suggested dietary and lifestyle adjustments, such as eating smaller, more frequent meals and losing weight.

At first, those treatments calmed Robert’s heartburn, but over the years their effectiveness waned and his symptoms progressed. Instead of contending with just heartburn, he eventually had difficulty keeping food down, to the point of throwing up soon after eating.

Hernia Adds to the Hurt

Around this time, Robert went in for an endoscopy to examine his esophagus for changes due to his long-term GERD. Dr. William Kosmala, Robert’s current gastroenterologist, conducted the procedure and discovered more than expected. As it turns out, Robert had a hiatal hernia, a condition causing his stomach to shift into his chest cavity. It is likely that this hernia was the culprit for his longstanding battle with GERD and had simply gone undetected for years, becoming worse with time as his stomach moved gradually from its natural position in his abdomen by pushing into his chest cavity.

Causes & Symptoms of GERD

GERD can be caused by:

• increased pressure on the abdomen from being overweight, obese or pregnant

• certain medications, including calcium channel blockers, painkillers and antidepressants

• smoking

• hiatal hernia

The most common symptom of GERD is regular heartburn, a painful, burning feeling behind your sternum and in the middle of your abdomen. Other symptoms of GERD can include:

• bad breath

• nausea

• pain in your chest or the upper part of your abdomen

• problems swallowing or painful swallowing

• respiratory problems

• vomiting

• wearing away of your teeth

Source: National Institute of Diabetes and Digestive and Kidney Diseases

Depending on the severity of a hiatal hernia, individuals with the condition may not have any symptoms or they may have symptoms ranging from mild reflux to those as intense as Robert’s, in which it’s difficult to even keep food down. GERD resulting from a hiatal hernia can be managed through diet and medication, but for some individuals, surgery may be the best option – this was the case for Robert.

Robotic Surgery to the Rescue

“Many patients with GERD, even those with an underlying condition, find significant relief by taking medication, specifically a group of medications called proton pump inhibitors,” explains Dr. Kosmala. “However, due to the mechanical nature of Robert’s problem and the degree to which it had developed, surgical remediation eventually became necessary.”

Dr. Paul Gordon, a cardiovascular and thoracic surgeon, performed Robert’s surgery at Palos Hospital. The surgery accomplished three tasks: pulling Robert’s stomach back into its natural position, repairing the hernia in his diaphragm, and wrapping the top portion of the stomach around the lower part of the esophagus to tighten it to prevent reflux.

To carry out this three-part operation, Dr. Gordon used the daVinci® Surgical System, a robotic system with several arms and a 3D scope camera controlled by the surgeon. According to Dr. Gordon, the daVinci® system was ideal for Robert’s surgery because it enabled him to perform precise surgical movements within the tight confines of the region of the chest cavity into which Robert’s stomach had moved.

Enjoying the Ride

It’s been nearly a year since Robert’s surgery, and after decades of battling unrelenting heartburn and nausea, today he says, “I feel great. I eat just about anything I want to without having reflux. I no longer have the discomfort of food and stomach acid backing up.”

Surgery has given Robert relief, and can be a good option for certain individuals. “I advise patients with GERD and underlying conditions, such as Robert’s hiatal hernia, to consider surgery when their symptoms are unmanageable through treatment with medications and dietary adjustments,” says Dr. Gordon. “Surgery should also be considered if you start to develop esophagitis, narrowing of the esophagus or some other complication. Patients should consult with their gastroenterologist when determining if surgery is a good treatment option for them.”

While Robert loves to travel, for a while his GERD symptoms kept him close to home. However, since his surgery, he has traveled to Colorado, where he hiked in the mountains with friends, and to Arizona, where he hiked again and attended a football game to watch his beloved Bears take on the Cardinals.

Thanks to his surgery, the road is once again wide open for Robert. “I feel like I have another 20,000 miles left under the hood,” he says. “And now I can truly enjoy the drive ahead.”

Talk to your doctor if you have any signs or symptoms of GERD. Need a doctor? Search by area and specialty here.