The Ultimate Guide to GERD Surgery

Chronic reflux can wear you down over time. Heartburn or regurgitation can disrupt sleep and daily life. Some patients ask if surgery gives longer control than medicine. This guide explains symptoms, testing, and procedure choices. It informs you but does not replace your personalized care.

If you have any of the following, seek urgent care now:

• Chest pain with shortness of breath.

• Pain that goes into the jaw or arm.

• Vomiting blood or black, tarry stools.

• Fainting or severe trouble swallowing.

• Fast, unexplained weight loss or rapidly worsening symptoms.

At NorCal Integrity Surgery in Los Gatos, Dr. Colin Dunn evaluates patients from Silicon Valley. This team focuses on testing-driven, personalized care.

What is GERD?

GERD means gastroesophageal reflux disease. It occurs when stomach contents flow back into the esophagus. The esophagus is the tube from mouth to stomach. Reflux causes symptoms or can injure the esophagus over time.

Common signs include heartburn and regurgitation. Heartburn is a burning feeling behind the breastbone. Regurgitation is sour or food-like fluid coming up into the throat. Nighttime reflux may cause cough, hoarseness, or worse asthma.

Plain words for common terms:

GERD: Long-term reflux that causes symptoms or esophagus injury.

Heartburn: Burning behind the breastbone, often after eating or lying down.

Regurgitation: Sour or food-like fluid coming back into the throat or mouth.

Hiatal hernia: Part of the stomach slips up through the diaphragm opening.

Esophagitis: Inflammation or injury of the esophagus from reflux.

Barrett’s esophagus: A change in the esophagus lining after long-term reflux.

Objective reflux evidence: Tests that show reflux, like endoscopy or pH testing.

If you are still unsure whether reflux causes your symptoms, start with general GERD information. If burning is the main problem, read about chronic heartburn. If fluids come up often, read the regurgitation section.

When should GERD surgery be part of the conversation?

Most people try lifestyle changes and medicines first. Common steps include weight control and avoiding trigger foods. Also avoid lying down right after eating. Common medicines are H2 blockers and proton pump inhibitors (PPIs).

Surgery is considered for structural problems or ongoing symptoms. It may be discussed when regurgitation persists despite acid control. Surgery is also considered for large hiatal hernia or severe esophagitis. Some patients prefer an alternative to long-term medicine. Careful testing is required before deciding on surgery.

Who might discuss surgery:

Surgery is not for a single bad day of reflux. It is chosen when tests, anatomy, and goals support it.

Symptoms that should be evaluated before surgery

A good workup separates reflux from other problems. Heartburn and regurgitation predict reflux better than throat-only symptoms. Other conditions can mimic reflux symptoms. Testing helps avoid the wrong operation. Symptom patterns and typical next steps:

If you have new chest pain, do not assume reflux. Seek immediate medical help for concerning chest pain.

Why reflux testing matters before GERD surgery

Surgery should match the diagnosis. Tests confirm whether reflux causes your symptoms. They also rule out conditions that make surgery unsafe. One such condition is achalasia. Achalasia is when the esophagus cannot push food down properly. Common tests and what they tell us:

Guidelines often recommend testing when endoscopy does not prove reflux. Testing helps choose the correct operation and reduces poor outcomes.

Main GERD surgery options

Surgery aims to strengthen the barrier between stomach and esophagus. The best option depends on anatomy, swallowing, hernia size, and goals. Testing findings help guide the choice. Common options:

Guidelines support surgery for objective GERD, large hernias, or severe esophagitis. These procedures work best when done by an experienced surgeon.

Fundoplication vs LINX

Both fundoplication and LINX aim to reduce reflux. They use different methods to strengthen the barrier. Compare the two:

Which is best depends on your anatomy, tests, and goals. Discuss options with your surgeon rather than deciding online.

How a hiatal hernia changes the plan

A hiatal hernia can weaken the reflux barrier. Part of the stomach moves up through the diaphragm opening. Not every hernia causes severe GERD. When a symptomatic or large hernia exists, surgery usually repairs it and treats reflux. Hernia findings and planning:

Small sliding hernia: May be repaired during reflux surgery.

Larger hernia: Often needs detailed repair planning.

Paraesophageal hernia: May require a separate risk discussion.

Hernia with dysphagia: Requires careful swallowing and motility tests.

Hernia after prior surgery: Needs review of records, imaging, and endoscopy.

If you were told you have a hiatal hernia, bring reports to the consultation.

What happens during GERD surgery?

Details depend on the chosen procedure. Many surgeries use small laparoscopic or robotic incisions. If a hernia is present, the surgeon first returns the stomach to the abdomen. Then the surgeon repairs the diaphragm opening. Finally the surgeon rebuilds the reflux barrier with a wrap or device. Key steps patients should expect:

Anesthesia: Surgery is done under general anesthesia.

Access: Most operations use small laparoscopic incisions.

Hernia repair: If present, the hernia is fixed first.

Reflux barrier reconstruction: A wrap or device is placed to reduce reflux.

Safety check: The surgeon evaluates and adjusts the repair.

Recovery instructions: Diet, lifting, and activity rules depend on the operation.

Dr. Dunn confirms the final plan after reviewing your tests and risks.

GERD surgery recovery

Recovery varies by operation, hernia repair, and health. Many patients stay at least one night after laparoscopic surgery. Light activity at home usually starts soon after surgery. Heavy lifting and strenuous activity are limited for weeks. Typical recovery topics:

Hospital stay: Some go home same day; others stay overnight.

Pain control: Discomfort is managed with short-term medicine.

Diet: Start liquids or soft foods and advance slowly.

Swallowing: Temporary difficulty is common and often improves.

Activity: Walking is encouraged; avoid heavy lifting for a time.

Work: Return depends on job demands and recovery progress.

Follow-up: Visits check swallowing, reflux control, and wounds.

Call your surgeon for fever, worsening belly swelling, uncontrolled pain, or persistent vomiting. Also call for breathing trouble, poor wound healing, or spreading redness.

Risks and possible side effects

All procedures have benefits and tradeoffs. The goal is less reflux and better quality of life. Risks include temporary swallowing problems and gas-bloat. You may have trouble belching or vomiting after some procedures. Reflux can recur or a hernia can return. Other risks include infection, bleeding, and anesthesia problems. Rarely, another operation or endoscopic dilation may be needed. Device-specific concerns apply to LINX and should be discussed. Testing and shared decision-making reduce the chance of choosing the wrong procedure.

Questions to ask at a GERD surgery consultation

A good consultation should help you decide. Bring endoscopy reports, pH studies, manometry results, and imaging. Also bring medication history and past surgical records. Helpful questions:

Do my tests prove GERD, or is more testing needed? Why it helps: Confirms whether surgery treats the right problem.

Do I have a hiatal hernia, and does it need repair? Why it helps: Clarifies anatomy and surgical planning.

Is my esophageal motility strong enough for the planned procedure? Why it helps: Reduces swallowing-related risk.

Which procedure fits my situation: fundoplication, LINX, or TIF? Why it helps: Moves from general options to personal candidacy.

What diet changes will I need after surgery? Why it helps: Prepares you for recovery.

What side effects matter most for my procedure? Why it helps: Sets realistic expectations.

What would make surgery a poor choice for me? Why it helps: Identifies contraindications and alternatives.

How will we evaluate symptoms if they persist after surgery? Why it helps: Plans for long-term follow-up.

Why consider NorCal Integrity Surgery for GERD evaluation?

Evaluating GERD for surgery needs more than treating heartburn. It needs a combined view of anatomy, reflux tests, and swallowing. Dr. Colin Dunn focuses on testing-driven, personalized discussions. What the practice emphasizes:

• Objective testing before invasive treatment to avoid unnecessary surgery

• Foregut-focused evaluation linking reflux, hernia, and motility findings

• Clear comparisons of fundoplication, LINX, TIF, and hernia repair

• Practical recovery planning for diet, activity, and follow-up

• Local access for Los Gatos and Silicon Valley patients

Learn more about Dr. Colin Dunn or request a consultation to discuss whether GERD surgery evaluation is right for you.

Frequently asked questions

Is GERD surgery only for people who do not respond to PPIs?

No. Surgery may suit persistent symptoms, severe esophagitis, or large hernia. It can also help patients who cannot tolerate medicine or who prefer surgery. Objective GERD confirmation is usually needed before surgery.

Do I need reflux testing before surgery?

Often, yes. Testing helps confirm abnormal reflux before invasive treatment.

Why do I need manometry before reflux surgery?

Manometry measures how the esophagus contracts when you swallow. It helps rule out achalasia and checks if the esophagus can tolerate surgery.

Is LINX better than fundoplication?

Not automatically. The best choice depends on anatomy, motility, and goals.

Is TIF the same as surgery?

TIF is an endoscopic partial fundoplication done through the mouth. It helps selected patients but differs from laparoscopic surgery or LINX.

Can a hiatal hernia be repaired at the same time?

Yes. Hernia repair is often combined with a reflux procedure when needed.

Will I stop reflux medicine after surgery?

Some patients reduce or stop medicines. This outcome cannot be guaranteed. Discuss goals with your surgeon.

What if my symptoms are mostly cough or throat clearing?

Extraesophageal symptoms need careful testing. Reflux may not be the only cause.

How long is recovery?

Many patients return to normal activities in several weeks. Recovery depends on the operation, hernia repair, and your overall health.

What if reflux returns after surgery?

Recurrence can happen. If symptoms return, we re-evaluate with endoscopy, testing, and imaging.

Request a GERD surgery consultation in Los Gatos

If you are comparing medicines, testing, fundoplication, LINX, TIF, or hernia repair, the next step is diagnosis-driven planning. NorCal Integrity Surgery can help match your symptoms to objective tests. We assess whether a hiatal hernia or motility issue alters the plan.

Request a consultation with Dr. Colin Dunn to start. Or call NorCal Integrity Surgery to schedule your visit.