When Is Acid Reflux Surgery Recommended?


If you’ve had difficulty managing symptoms of the chronic, more severe form of acid reflux known as GERD (Gastroesophageal Reflux Disease) and medications and dietary changes haven’t helped, you may be wondering if acid reflux surgery is a good option for you. While surgical treatment isn’t the right choice for everyone, it can often be an effective solution for those who haven’t found relief with other treatments. 

In this article, we’ll address when acid reflux surgery is recommended and how it works and consider its effectiveness and potential side effects. 

We understand how severe heartburn and acid reflux/GERD symptoms can interfere with your quality of life. At RMG Gastroenterology, our board-certified gastroenterologists provide comprehensive care for GERD and other gastrointestinal issues to help you manage your condition and find relief. If you’re seeking support for digestive system challenges, we invite you to request an appointment with us today. 

When is Acid Reflux Surgery Recommended?

We typically don’t recommend acid reflux surgery as a first option. In most cases, we begin with conservative treatments, such as a combination of medication and lifestyle changes to help reduce stomach acid and minimize symptoms. 

This may include prescription medications, weight management, dietary adjustments, avoiding trigger foods and other conservative approaches. These strategies work well for many people.

However, surgery may be considered when symptoms persist despite conservative treatment or when GERD negatively impacts your quality of life.

You may be a candidate for acid reflux surgery if:

  • Conservative treatments don’t alleviate reflux symptoms.
  • Medication produces side effects.
  • GERD is severe and interferes with your daily life.
  • You have chronic inflammation or esophageal damage.
  • You have a hiatal hernia that contributes to reflux symptoms.
  • You have Barrett’s Esophagus, a condition associated with long-term acid exposure.

Before recommending surgical intervention, we’ll evaluate your esophagus using a procedure known as an upper GI endoscopy. This will allow us to view your upper GI system so we can provide an accurate diagnosis.

What Happens During Acid Reflux Surgery?

The most common surgical intervention for GERD is known as a Nissen fundoplication. 

The procedure involves wrapping the upper portion of the stomach (fundus) around the lower esophageal sphincter (LES). This strengthens the valve between the stomach and esophagus and creates a barrier that helps prevent acid reflux. 

It is typically performed laparoscopically, during which surgeons use several small incisions and tiny camera-guided instruments. Compared to open surgery, this minimally invasive procedure usually means there will be less pain and shorter recovery times. 

The surgery is performed under general anesthesia and normally takes between 1 and 3 hours. If you also have a hiatal hernia, it may be repaired during the same procedure. 

After surgery, you’ll stay in the hospital for 1–2 days. Recovery includes a liquid or soft-food diet for the first few weeks, followed by a gradual return to your normal eating habits.

As you heal, you may experience a sore throat, mild difficulty swallowing, temporary abdominal soreness, bloating and fatigue. 

How Effective is Surgery for Acid Reflux?

For the right patients, acid reflux surgery can be very effective, offering significant symptom relief. 
 Benefits of acid reflux surgery

Patients who have a confirmed GERD diagnosis and who have responded at least somewhat positively to acid-reducing medication prior to surgery experience the most favorable outcomes.

While surgery can significantly improve daily quality of life for many people with severe, persistent GERD, in some cases symptoms may return, and a small percentage of patients may eventually need another procedure.

We encourage you to reach out to us if you are considering surgery. At RMG Gastroenterology, we’ve worked with hundreds of patients with GERD. We’ll explain the surgery and discuss whether it’s an option for you. 

Are There Any Side Effects of GERD Surgery?

Any surgery carries potential risks and side effects. Because GERD surgery tightens the valve between the stomach and esophagus, you may experience side effects related to that modification. 

These side effects are often temporary and improve as your body heals, though some patients may experience longer-term side effects.

 Short-term side effects may include:

  • Temporary difficulty swallowing
  • Abdominal discomfort
  • Increased flatulence
  • Sore throat
  • Bloating
  • Fatigue

Potential longer-term side effects may include:

  • Trouble vomiting
  • Difficulty burping
  • Gas bloat syndrome (fullness, pressure or abdominal swelling caused by trapped gas)
  • Feeling overly full
  • In some cases, ongoing swallowing issues 

You may be able to manage some of these side effects by making lifestyle changes such as eating more slowly, chewing food carefully and limiting carbonated beverages.

Side effects vary significantly by person. While some will improve over time, others may require long-term dietary changes, such as smaller, more frequent meals and other adjustments. 

We encourage you to speak to your GI specialist or surgeon about potential side effects and how to manage them effectively. 

RMG Gastroenterology: Expert, Comprehensive Care for Acid Reflux and GERD

Often, acid reflux and GERD can be managed successfully with a combination of medications and lifestyle changes, and that’s where we start. However, if you have severe or persistent GERD that doesn’t respond to a conservative approach, we may make a referral for a surgical option.

The best way to determine whether you’re a candidate for acid reflux surgery is to speak with our expert gastroenterologists. We can review your symptoms, and if necessary, perform an upper GI endoscopy to evaluate your esophagus and then create a personalized treatment plan based on your results.

If you’re experiencing digestive system challenges, we invite you to request an appointment with us today. We can help you manage your condition, find relief and improve your quality of life.

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