Surgery Versus Drugs for GERD

Gastroesophageal reflux disease (GERD) can be treated using both surgical and non-surgical approaches. The decision to use surgery versus drugs depends on the severity and frequency of symptoms, response to medication, and the risk of complications.

Most people with GERD are initially treated with medications such as antacids, H2 receptor antagonists, and proton pump inhibitors (PPIs) to reduce the amount of acid produced by the stomach. These medications are usually effective and can provide relief from symptoms in the majority of cases. However, in some cases, medication may not be sufficient to control symptoms, or the patient may develop side effects from long-term use of these drugs.

In cases where medication is not effective, or where there are complications such as bleeding, narrowing of the esophagus, or the presence of a hiatal hernia, surgery may be recommended. The two most common surgical approaches for GERD are laparoscopic Nissen fundoplication and magnetic sphincter augmentation (LINX).

Laparoscopic Nissen fundoplication involves wrapping the upper part of the stomach around the lower esophagus to create a valve that prevents stomach acid from backing up into the esophagus. This procedure is usually performed under general anesthesia and involves several small incisions in the abdomen.

Magnetic sphincter augmentation (LINX) is a newer procedure that involves placing a magnetic ring around the lower esophageal sphincter to strengthen it and prevent acid reflux. The procedure is performed through small incisions and is less invasive than Nissen fundoplication.

Both procedures are generally safe and effective, but they do carry some risks, such as bleeding, infection, and difficulty swallowing. The choice of surgery versus medication should be made after careful consideration of the patient’s symptoms, medical history, and risks and benefits of each approach.