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Acid Reflux Surgery

Acid reflux surgery is also called fundoplication surgery and the aim is to completely cure the acid reflux.

No-one likes to take pills and everybody would prefer a complete cure for their condition. This approach offers a possibility of cure. Like all operations, when it works well, the results are fantastic. But before you decide to have surgery, you need to balance the benefits against the risks.

What is anti-reflux fundoplication surgery?

Please look at these videos which are provided by other people. They explain very simply how the surgery works.

Please note that the older ‘open’ operation is presented first and the newer ‘keyhole’ operation is shown second. Most people now have keyhole surgery.

This short clip just shows the operation itself but has no explanation.

This is a rather longer animation with excellent voice-over. It covers not just the surgery but also explains how reflux occurs and why the surgery is successful.

Benefits of Surgery

Most people with reflux symptoms have heartburn (a burning sensation starting at the bottom of the breastbone and rising into the chest). Others have chest pain, cough or even a hoarse voice (click here for more details) Quite a few people are aware of regurgitation of food or acidic or foul tasting liquid into the back of the mouth. It is these people who tend to get the greatest benefits from anti-reflux surgery.

Successful surgery means no more need to take medicines. For people who have disturbed sleep, it means no more waking up at night. Most people who eventually opt to have surgery are very pleased by the significant improvement it brings in their quality of life.

Risks of Surgery

Like all things in life, surgery has its risks.

The first risk is that it fails to heal the problem. Large medical studies suggest that around 8 out of every 10 people who undergo the surgery are happy or very happy with the result.

The second risk is that even if the surgery works in the short term, the benefits may not last forever. It seems that more than 7 out of 10 people will continue to enjoy the benefits of surgery for at least 10 years. No-one really knows what the success rates are after 20 years, but they are likely to be similar.

Side Effects of Surgery

After this operation, almost everyone finds it difficult to eat solid foods for a short while. The surgeon usually gives instructions on following a sloppy diet until everything settles down, usually within 2-4 weeks.

For one in ten people, the difficulty swallowing persists and may need further treatment by the surgeon or by a gastroenterologist, to make it better.

Having a fundoplication wrap means that most people are now unable to bring back stomach contents. This is good because the reflux is abolished. The unfortunate side effect is that most people can no longer belch. The wind in the stomach therefore gets trapped and most people suffer with abdominal bloating (called the ‘gas-bloat syndrome) for a few months at least. This usually, but not always, settles down.

Should I have surgery?

This is always a personal decision but our guiding philosophy is that surgery should never be the first choice.

We would recommend carefully looking at your diet, trying medication and only if these fail to control symptoms, or if you have complications, should you undergo surgery.

Some people are not comfortable with taking medicines long term, or have side effects from medicines. Surgery may be the right approach for these people.

Remember that the diagnosis of acid reflux is not always clear-cut and a formal positive diagnosis using a pH test  or the newer BRAVO pH study should always be done before have acid reflux surgery.

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