You may experience acid reflux due to conditions such as hiatus hernia, a stomach ulcer, bacterial infection of the stomach, or gastro-oesophageal reflux disease (GORD or GERD). Sometimes, these conditions don’t respond to lifestyle changes or medication and need further intervention.
In this article, we list the surgical options available if you suffer from severe acid reflux and when they might help you.
What are my treatment options for severe acid reflux?
There are many ways to treat acid reflux. Lifestyle changes are one of the main ways to help elevate symptoms. These include dietary changes, smoking cessation, and weight loss.
Medication can also be administered to help lessen symptoms. Antacids, proton pump inhibitors (PPIs), and histamine (H2) blockers can help with acid reflux.
A combination of medication and lifestyle changes can help treat symptoms more effectively. They work together to control stomach acid levels.
However, if these aren’t effective and you don’t see any results, we recommend surgical treatment to help reinforce the lower oesophageal sphincter (LOS).
These surgeries can include:
- Stretta
- Transoral incisionless fundoplication (TIF)
- Laparoscopic insertion of a magnetic bead band (LINX)
- Laparoscopic Nissen fundoplication (LNF)
- Endoscopic injection of bulking agents
- Endoluminal gastroplication
- Endoscopic augmentation with hydrogel implants
- Endoscopic radiofrequency ablation
Most of these procedures are fairly new, so their long-term effects are limited. However, the National Institute for Health and Care Excellence (NICE) has said they are safe to administer.
Below, we will run through some of the key surgeries your surgeon may perform.
Surgery options
Stretta
This procedure is recommended for those who have a loose gastroesophageal (GE) junction valve due to GORD or laryngopharyngeal reflux (LPR).
Stretta involves passing an endoscope (a thin, flexible tube) through the mouth and down the oesophagus (food pipe).
The instrument uses radiofrequency energy to thicken and improve the LOS, a ring of muscle that acts as a valve between the food pipe and the stomach.
One benefit of this procedure is that it is minimally invasive, meaning there is no need for an incision. It is also a viable option for those not eligible for major surgery since there is no need to operate on the oesophagus directly through open surgery.
Nissen fundoplication (NF)
This procedure is typically recommended to those who have GORD, hiatus hernia or Barrett’s oesophagus and find that medication is no longer effective.
There are two types of Nissen fundoplication surgeries:
- Laparoscopic – this involves small incisions and small cameras to see inside your body and perform the operation
- Open – this involves large incisions so a doctor can have access to your body with more space to work and larger instruments to perform the operation
Both procedures aim to wrap the upper stomach around the lower oesophagus to help repair the GE junction valve.
Many patients have seen the benefits of this operation, including symptoms being resolved/elevated, fast recovery, low pain, and shorter hospital stays. However, this procedure does carry some risks, including results that do not last after surgery and a higher chance of infection at the surgery site.
Laparoscopic insertion of a magnetic bead band (LINX)
This procedure is suitable for patients who have been rejected from having major surgery or do not want major surgery to help treat their severe acid reflux.
It involves implanting a ring of magnetic beads around the lower part of the oesophagus to help strengthen it and keep it closed when not swallowing, preventing stomach acid from rising into the oesophagus.
Like Nissen Fundoplication, this is done laparoscopically (keyhole surgery) and under general anaesthetic. Because the stomach or oesophagus is not altered surgically, the hospital stay can be brief with this procedure.
You may see benefits such as reducing or eliminating symptoms and/or medication, faster recovery, and a quicker return to a normal diet. The most common side effects of the surgery are difficulty swallowing, post-operative pain, and temporary bloating of the stomach.
Transoral incisionless fundoplication (TIF)
This procedure is recommended as an alternative treatment to more invasive procedures that help treat conditions such as GERD and esophagitis.
It involves operating on your GE junction valve using an endoscope and a special fundoplication device. This device wraps the top of your stomach securely around the lower part of your oesophagus to create a tighter valve between them. It will be secured with fasteners, surgical staples, or stitches.
Book an appointment
Surgery can be an essential treatment for your condition if other treatments are ineffective.
Our gastroenterologist will thoroughly assess and monitor your condition to determine the most suitable surgical treatment for you. We also offer a second opinion service.
Get in touch today to book an appointment with our gastroenterologist.
