Surgery Options for GERD
Acid Reflux and GERD
reflux occurs when stomach acid flows backward into the esophagus. This causes
heartburn and other symptoms. Chronic or severe acid reflux is known as
gastroesophageal reflux disease (GERD).
or moderate reflux symptoms can often be relieved with diet and lifestyle
changes. Over-the-counter and prescription medications can also help with
symptom relief. Medications used to treat GERD include:
- H2 blockers
- proton pump
some people aren’t helped by lifestyle changes or medications. Surgery may be
an option for those people. Surgery focuses on repairing or replacing the valve
at the bottom of the esophagus that normally keeps acid from moving backward
from the stomach. This valve is called the lower esophageal sphincter (LES). A
weak or damaged LES is what causes GERD.
GERD can develop into a condition called Barrett’s esophagus. This condition
increases the risk of esophageal cancer. However, esophageal cancer is rare,
even in people with Barrett’s.
When to Consider Surgery
may be recommended if you have serious GERD complications. For example, stomach
acid can cause inflammation of the esophagus. This may lead to bleeding or
ulcers. Scars from tissue damage can constrict the esophagus and make
for GERD is usually a last resort. Your doctor will first try to manage your
symptoms with changes to your diet and lifestyle. This gives relief to most
people with the condition. If that does not give you relief, they will try
long-term medications. If these steps do not relieve the symptoms, then your
doctor will consider surgery. You might also consider surgery to avoid taking
are several surgical options that may help to relieve GERD symptoms and manage
complications. Speak with your doctor for guidance on the best approach to
manage your condition.
your GERD requires surgery, you should be sure and discuss the cost of your
surgery with your doctor and the hospital. The costs vary greatly depending on
your insurance, the hospital, type of surgery, and other factors.
This is the standard surgical
treatment for GERD. It tightens and reinforces the LES. The upper part of the
stomach is wrapped around the outside of the lower esophagus to strengthen the
Fundoplication can be performed as
an open surgery. During an open surgery, the surgeon makes a long incision in
your stomach to access the esophagus. It can also be performed as laparoscopic
surgery. This type of surgery involves several smaller incisions. Miniaturized
instruments are used to make the process less invasive.
The preparation for this surgery
is typical of that for any surgical procedure. It may include:
- a clear liquid
diet 1-2 days before surgery
- not eating on the
day of surgery
- taking a medication
to cleanse your bowels the day before surgery
Ask your doctor for specific preparation
instructions, as they may differ due to your individual medical history.
This type of surgery generally has
a very good rate of long-term success.
TIF (Transoral Incisionless Fundoplication)
This procedure is used when open
fundoplication is not appropriate. It creates a barrier between the stomach and
the esophagus. The barrier prevents reflux of stomach acid.
This procedure doesn’t require incisions.
A device called an EsophyX is inserted through your mouth. It creates several
folds at the base of the esophagus. The folds form a new valve. Since it does
not require incisions, this can be a good option for people with GERD. If
medications do not relieve your GERD, but you do not want more invasive
surgery, this may be an option you prefer.
The preparation for this surgery is
similar to that of the preparation for fundoplication, but may not require as
many steps. Check with your doctor about the right preparations for you.
This procedure is
performed with an endoscope. It is usually done as an outpatient procedure.
This is a thin, flexible tube that can be threaded into your esophagus. An
electrode at the end of the tube heats your esophageal tissue and creates tiny
cuts in it. The cuts form scar tissue in the esophagus. This blocks the nerves
that respond to refluxed acid. The scar tissue that forms also helps strengthen
the surrounding muscles.
shows effectiveness in relieving or even eliminating the symptoms of GERD.
However, this is still a fairly new procedure, so long-term results are
for this procedure is much like preparing for fundoplication. But, you should
check with your doctor about the correct preparations for you.
This procedure is
generally less expensive than fundoplication. It’s important to check with your
insurance to be sure it is covered and what the actual cost will be for you.
This system also
uses an endoscope. Stitches are made to form pleats in the LES. This
strengthens the LES. The procedure is not as common as others mentioned above.
However, it is another option for you to discuss with your doctor.
This procedure is
not covered by all insurance carriers. It is important that you discuss the
costs of this, and all, procedures with your insurance carrier, your doctor,
and your hospital prior to deciding on the correct procedure for you.
surgery uses a special device called a linx. It’s a ring of tiny magnetic
titanium beads. When wrapped around the LES, the linx strengthens the
the beads are magnetized, they move together to keep the opening between the
stomach and esophagus closed. Food can still pass through normally.
this is a minimally invasive surgery recovery time is usually considerable
shorter than traditional surgery. There is also less pain related to this type
is a relatively new procedure but shows good results for relieving acid reflux
is slightly different for each type of surgery, but depends primarily on
whether your surgery is laparoscopic or traditional. While laparoscopic surgery
has a quicker recovery time and less pain that traditional, it may not be
appropriate for every person with GERD. Your doctor and surgeon will be able to
decide which is best for you.
fundoplication surgery is the most common. The traditional or open surgery
requires about a week in the hospital and then about six weeks before you are
able to return to work. The laparoscopic fundoplication surgery requires only a
few days in the hospital with the patient able to return to work after one
week. There is also less pain after this less invasive procedure.
to any surgery for GERD, your doctor will try dietary changes, then
medications. If those do not give you relief then, surgery will be suggested.
more popular surgeries used to treat GERD, the outlook is very good. In most
people with GERD, they relieve or even eliminate their symptoms. Some of the
newer or less common surgical procedures have not had enough studies yet to
determine their long-term success.
surgery is usually a last resort for treating GERD, it can also be considered
for eliminating the need for long-term medications. You should consider all
options before deciding on surgery. You should also consider the costs of each
procedure, as the costs can vary. Checking with your insurance prior to
deciding on a procedure is also important. Some of these procedures are not
covered by insurance.
doctor will be able to help you determine which procedure will help you most.
They will also be able to ensure that you are a good candidate for the