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Treating Heartburn With Surgery

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Minimally Invasive (Endoscopic) Procedure for GERD

By using endoscopy, doctors can also treat GERD in the esophagus without an incision in the abdomen. Endoscopy for GERD uses a flexible tube that is placed through the mouth and into the esophagus and stomach. The tube contains a light and camera to visualize the inside of the body. Through the endoscope, doctors can also take tissue samples and perform procedures using other tools. 

Minimally invasive endoscopic treatments for GERD involve:

Endoscopic procedure. A doctor operates with a limited set of small surgical tools at the tip of an endoscope. Using a procedure called the Esophyx system, the doctor tightly binds the end of the esophagus to the top of the stomach. With the EndoCinch system, stitches are placed in the lower esophagus to form pleats that strengthen the area.

Radiofrequency treatment. This is also known as the Stretta procedure. During endoscopy, high-energy waves are directed into the wall of the lower esophagus. The esophagus responds by producing small amounts of scar tissue. In most people, this reduces heartburn and other acid reflux symptoms. More than one radiofrequency treatment may be required to achieve a good result.

Endoscopic procedures are usually effective but are not as good as surgery at treating acid reflux, generally speaking. However, they offer the significant advantages of not requiring incisions, general anesthesia, or a hospital stay.

What to Expect After Surgery for GERD

Five or more years after fundoplication for acid reflux, 90% to 95% of people surveyed report feeling satisfied with their surgery and its results. More than 80% of people describe relief of their symptoms as good or excellent.

Surgery for acid reflux frequently does not eliminate all symptoms, however. Some people need to continue to take acid-suppressing medications after heartburn surgery to control the remaining symptoms. Nevertheless, they usually report satisfaction with their heartburn surgery results.

Surgery for acid reflux has low risks in general. The risks of surgery include:

  • Difficulty swallowing after the surgery.
  • A frequent feeling of bloating (gas bloat syndrome).
  • The need for repeat surgery in up to 10% of people.
  • Wound infection.

Before undergoing heartburn surgery, it's important to discuss these and other risks with your doctor.

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WebMD Medical Reference

Reviewed by Michael W. Smith, MD on June 28, 2013
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