There are several options for gastroesophageal reflux disease surgery. All surgeries involve narrowing or closing off the lower end of the esophagus to prevent acid reflux.
Surgeons perform some gastroesophageal reflux disease (GERD) procedures as open surgeries through an incision in the abdomen. Other procedures are laparoscopic surgeries involving tiny incisions. Surgeons may also use non-surgical options that they perform as outpatient procedures.
Medication and lifestyle adjustments, such as diet changes, are typically the first steps for managing GERD. However, surgery could be an option if these do not help.
This article explores GERD surgery options, recovery time, complications, and success rates. It also explores other ways to manage GERD.
Doctors may suggest surgery or other medical procedures for GERD if a person sees no relief from medications and has complications from the condition, such as bleeding or ulcers. There are various procedures that surgeons may use to help ease a person’s GERD symptoms. They include:
Fundoplication is the
Surgeons may perform fundoplication as laparoscopic, or keyhole, surgery, or as an open procedure. Open surgery is more invasive, and the surgical wound is much larger, meaning that recovery time is often longer.
The Linx is a tiny ring of magnetic titanium beads strung together. The surgeon wraps the Linx around the lower esophageal sphincter during the procedure to compress and strengthen the area.
The magnetic nature of the Linx allows them to open and close so food can pass through, usually while preventing stomach acid from entering the esophagus.
The procedure is
Transoral incisionless fundoplication (TIF)
TIF is a way to treat GERD symptoms without surgery by restoring the natural reflux barrier. If fundoplication is not a suitable option for someone, doctors may choose the TIF procedure.
During TIF, a surgeon uses a special tool called the EsophyX device. They insert the device into the mouth and down the esophagus. The device creates skin folds at the bottom of the esophagus to create a new stomach valve that prevents stomach acid reflux.
Although an individual requires anesthesia, the necessary recovery time is
The Stretta procedure uses radiofrequency energy and an endoscope. Surgeons
During the Stretta procedure, the surgeon inserts an endoscope down the esophagus. This tube delivers radiofrequency waves to the area where the esophagus joins the stomach.
The radio waves create tiny cuts in the esophageal tissue. As these cuts heal, they form scar tissue that strengthens the area and blocks the nerves that respond to acid reflux.
The endoscope also delivers water to prevent any heat damage to other areas of the body.
Stretta appears safe. In a 2013 review, the authors noted that in more than 15,000 Stretta procedures, there were only 29 adverse events or problems.
Recovery time may vary depending on the type of surgery and the person. More invasive surgeries require a longer recovery time.
Typically, people spend 1–3 days in the hospital after GERD surgery. The inpatient stay allows doctors to monitor the person. A person can leave the hospital if they can eat, drink, and swallow without problems and are not experiencing any side effects.
Usually, patients must follow a diet of soft, puréed food or liquids only following GERD surgery. These dietary restrictions vary depending on the individual, but most patients gradually return to a solid diet over 2–8 weeks.
Additionally, surgeons may recommend that people take only crushed or liquid medications following the surgery and for several weeks as they recover.
With Linx and other minimally invasive procedures, doctors may perform them as outpatient procedures or with a
Laparoscopic GERD surgery typically has excellent success rates. In short-term studies of up to 5 years and long-term studies of up to 10 years, most people report they are extremely satisfied with the surgery, their symptoms have reduced, and their quality of life has improved.
Most people no longer need reflux medication following GERD surgery.
As with any surgery, there are risks and complications of GERD surgery,
- problems swallowing if the stomach wraps around the esophagus too tightly
- the esophagus moving so that the stomach no longer supports the valve
- heartburn that returns
- bloating, discomfort, or excess gas
Because the junction of the esophagus and entrance to the stomach is complex, the surgical correction also can weaken over time. Up to 30% of people who have the fundoplication procedure experience structural complications.
Having any surgery is a big step. Often surgery is the last resort, and people should first try lifestyle adjustments and medications to lessen their GERD symptoms. These may
- changing diet, including avoiding alcohol, orange juice, or tomatoes
- maintaining a moderate weight
- keeping the head elevated while sleeping
- quitting smoking
- taking over-the-counter GERD medications, such as antacids
If taking these steps does not relieve symptoms, a doctor may recommend prescription strength H2 blockers or proton pump inhibitors (PPIs). People can buy versions of these medications over the counter, although they may not offer the same results as prescription-strength medications.
H2 blockers and PPIs decrease the amount of acid the stomach makes, allowing the esophagus to heal. PPIs are more effective and can heal the esophageal lining in most individuals.
If a person has GERD, stomach acid enters the esophagus, which connects the mouth and stomach. Doctors call this acid reflux. It can irritate and damage the lining of the esophagus.
Many people have occasional acid reflux or gastroesophageal reflux (GER), especially after eating spicy food or a large, heavy meal. However, GERD is a chronic condition that involves frequent symptoms at least twice or more each week.
The American College of Gastroenterology estimates that 20% of people in the United States have this condition.
Symptoms of GERD include:
- a burning sensation in the chest, called heartburn
- chest pain
- problems with swallowing
- feeling like there is a lump in the throat
- regurgitation of food or stomach acid
A person may have these symptoms because the muscles that should form a seal between the stomach and esophagus become weak or do not close normally.
If a person does not seek treatment for GERD, serious complications can occur over time, including esophageal cancer.
Some people can manage GERD with dietary and lifestyle changes and medications. However, some require surgery to help ease the symptoms.
An individual needs to know if surgery is the best option for them. Here are some questions that may help an individual understand their treatment options:
- What are the medical treatment options that you recommend?
- What are the surgical treatment options that you recommend?
- If I don’t have surgery, will my GERD worsen over time?
- What are the side effects and risks of the surgery?
- Am I a suitable candidate for laparoscopic surgery?
- How successful are these antireflux surgeries?
- Will I ever need further surgery?
- What will the recovery process look like?
GERD is a gastrointestinal condition where stomach acid rises into the esophagus, causing heartburn and other symptoms. Without treatment, GERD can lead to severe complications, including esophageal cancer.
GERD surgery is an option for individuals who cannot manage the condition with medication and lifestyle changes.
There are various options, including fundoplication, TIF, Stretta, and Linx. Surgeons may perform these as open or laparoscopic surgeries, or non-surgically in the case of Stretta.
Surgeries have excellent success rates, and most people no longer require medications to manage GERD.