Gastroesophageal reflux disease (GERD) surgery is a surgical procedure designed to address the weakening sphincters in the esophagus that lead to GERD. The surgery tightens the sphincter between the stomach and the esophagus to make it harder for stomach acid to back up into the esophagus. This treatment is usually recommended when medications do not work and a patient's GERD is severe and painful. Some studies have suggested that medication and GERD surgery can be equally effective in many patients. Patients should make sure they are working with an experienced gastroenterologist when they evaluate treatment options.
In patients with GERD, stomach acid backs up into the esophagus. This causes immediate pain in the short term, and in the long term, it can lead to cellular changes, inflammation, infection, and an increased risk of cancer. Treatment for this condition can be approached from a number of perspectives, including prescribing antacid medications, changing a patient's diet, and adjusting a patient's exercise routines. If these measures do not work, surgery may be proposed as an option.
The most common form of GERD surgery is fundoplication, where the upper part of the stomach is surgically wrapped around the base of the esophagus to reinforce the sphincter and prevent stomach acid from being forced in the wrong direction. Another surgical treatment is gastropexy, where the stomach is fixed to the diaphragm to address GERD. GERD surgery can also involve implanting an artificial valve to replace the damaged and malfunctioning sphincter.
GERD surgery is invasive, although it may be possible to use endoscopic techniques for surgery to reduce the size of the incision and shorten healing time. The surgery can come with complications including adverse reactions to anesthesia and infections. After surgery, the patient will need to make some dietary modifications during the healing phases, and may need to make permanent lifestyle changes to prevent acid buildup from occurring in the future.
Before GERD surgery, patients should ask their surgeons why the surgery is being recommended, if there are alternatives available, what the expected outcome for the surgery is, and how it will be performed. Surgeons can provide patients with comprehensive information about proposed medical procedures and are usually happy to talk with patients who want to be more active in their medical treatment. It is also advisable to ask about surgical aftercare in advance, so any necessary preparations at home can be made ahead of time.