Most patients with GERD do not need surgery. However, if surgery is needed, a surgeon should be consulted to discuss the pros and cons of surgical treatment for GERD.
The indications for surgery in the patient with GERD include:
- Endoscopic and/or symptomatic failure of medical treatment of GERD
- Recurrence despite PPI therapy
- Volume regurgitation, dysphagia (difficulty swallowing)
- Atypical oesophageal and extra-esophageal symptoms
- Large hiatal hernias (>4 cm) (upper part of the stomach moves above the diaphragm)
- Barrett's oesophagus
- Stricture formation (narrowing of the gullet lumen)
- Poor oesophageal peristalsis
- Prolonged reflux episodes (>5 min) on pH study
- Pathological bile testing