Should I have surgery for my acid reflux?

Lots of people have acid reflux (heartburn), and most can control their symptoms with diet modification (avoid caffeine, acidic fruits, chocolate, and alcohol) or lifestyle modification (do not eat within 5 hours of going to bed, elevate the head of your bed on cinder blocks, lose weight). Others take acid-reducing medication, such as Omeprazole or Zantac. When reflux symptoms, like chest pain, chronic coughing or clearing your throat, frequent hoarseness, and a bitter taste in the back of your throat, are not controlled with these measures, many people get good control of their symptoms with anti-reflux surgery. I have been performing this operation, called a Nissen Fundoplication, for the past 17 years, and for vast majority of patients surgery significantly reduces their heartburn symptoms. The procedure is performed with six small incisions in the abdomen, using a television camera to visualize the anatomy. First I repair the opening in the chest where the esophagus enters the abdomen (the hiatal hernia), and I then wrap the stomach around the esophagus to create a valve that minimizes stomach acid reflux (a fundoplication). Surgery takes about an hour and I usually keep you overnight in the hospital for observation. Most people just need one week off of work, and I keep patients on a restricted diet (initially liquid, then soft foods) for 3 to 6 weeks. You may always have to think about how you eat your food after this surgery (small bites, chew well), since big, bulky bites might get hung up briefly where the stomach is wrapped around the esophagus. Some people continue to take medication for acid after surgery, but usually their symptoms are fairly mild. I usually recommend an endoscopy (EGD) before surgery to make sure there are no other problems with the esophagus, and I might need other xrays or measurements of acid in the esophagus to confirm that surgery will help you. Call for an appointment, I will be happy to review your symptoms and the operation to see if it can benefit you.

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