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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 include:
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 GERD.
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.
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 muscles.
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 sphincter.
Because the beads are magnetized, they move together to keep the opening between the stomach and esophagus closed. Food can still pass through normally.
Written by: Robin Madell and Diana K. Wells
Published on: Nov 04, 2014
Medically reviewed on: Mar 02, 2016: Mark R Laflamme, MD
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