Surgery Options for GERD
Acid reflux occurs when stomach acid flows
backwards into the esophagus. This causes heartburn and other symptoms. Chronic
or severe acid reflux is known as gastroesophageal reflux disease (GERD).
Mild 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
- H2 blockers
- proton pump inhibitors (PPIs)
Unfortunately, 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
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 swallowing difficult.
Untreated GERD can also 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.
There are several surgical options
that may help to relieve GERD symptoms and manage complications. Surgery for GERD is usually a last resort. Most doctors use it only when
other treatments have failed to relieve symptoms. For some people, surgery is a
better option than a lifetime of managing drugs and discomfort. Speak with your
doctor for guidance on the best approach to manage your condition.
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 sphincter.
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.
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.
This procedure is performed with an endoscope. 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
Bard EndoCinch System
This system also uses an endoscope. Stitches are made to form pleats in
the LES. This strengthens the LES.
This 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
Because the beads are magnetized, they move together to keep the opening
between the stomach and esophagus closed. Food can still pass through normally.