The most common reason for surgery is heartburn that doesn't go away with medications and lifestyle changes. Surgery may also be an option when you have:
- Severe inflammation of your esophagus, the tube that runs from your mouth to your stomach
- A narrowing of your esophagus that's not caused by cancer
- Barrett's esophagus, a change in the cells because of acid reflux
Before surgery, you'll probably get tests to check how well the muscles in your esophagus work, including esophageal manometry and esophageal motility studies.
Because you're taking a risk with any operation, you should consider surgery for acid reflux or GERD (gastroesophageal reflux disease) only after other treatments don't work, and when there's a good chance the operation will turn out well.
The main surgery for stubborn heartburn is called fundoplication. The surgeon can either directly touch the parts of your body they're working on (open fundoplication), or they can use special tools, including a thin tube with a light and camera called a laparoscope, to operate on you from the outside.
Your surgeon will cut into your abdomen: one large cut for open surgery, or a few small ones for laparoscopic surgery. Then they'll wrap all or part of the top part of your stomach around the lower part of your esophagus and sew it in place. This tightens the esophagus, which helps prevent stomach acid from backing up into it.
With the LINX procedure, your doctor uses a laparoscope to put a ring of titanium beads around the outside of your lower esophagus. This strengthens the valve between the esophagus and stomach. Food and liquids can still pass through.
These are usually the first things your doctor will do. They'll put a flexible tube, called an endoscope, through your mouth and into your esophagus and stomach. The tube has a light and camera so they can see the inside of your body. Through the endoscope and using special tools, they can also take tissue samples and do surgery.
With a set of small tools at the tip of an endoscope, they can tightly bind the end of the esophagus to the top of the stomach. Or they could place stitches in the lower esophagus to form pleats that strengthen the area.
In the Stretta procedure, or radiofrequency treatment, the doctor directs high-energy waves into the wall of the lower esophagus to create small amounts of scar tissue. This will usually lessen heartburn and other acid reflux symptoms. You may need more than one treatment for a good result.
These procedures are often effective, although they may not work as well as surgery. But they don't require cutting into your belly, putting you under general anesthesia, or a hospital stay.
What to Expect Afterward
You'll have a shorter recovery time and less pain with laparoscopy. Plus it doesn't leave a large scar. It's considered "minimally invasive."
Most people are satisfied with their surgery and its results. But surgery won't get rid of all your symptoms, and the surgery has a failure rate of 10% to 15%. You may need to keep taking medication. About 1 in 10 people will need to have surgery again.
These operations are generally pretty safe and usually don't cause other problems. You might:
- Have a hard time swallowing after the surgery
- Feel bloated often, called gas bloat syndrome
- Get an infection where you were cut
You should talk to your doctor about the pros and cons in your situation to decide whether surgery is a good choice for you.