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When to do anti-reflux surgery

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Professor Lovat
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One of the contributors to the study day was Mr Abrie Botha. He is a very experienced upper GI surgeon. He pointed out that the key to success for anti-reflux surgery is to make sure it is only offered to the right people. If chosen correctly, a paper from 2009 (by Broeders et al) showed 92% of people had resolution of their reflux symptoms.

In this study, the majority of people who had surgery said that they would choose it again, which is a good sign!

Approximately one quarter of people ended back on their proton pump inhibitor medication at the end of the study.

Choosing suitable people for surgery is crucial.

Candidates who are likely to get benefit from surgery include:

  • People with confirmed acid reflux which respond well to PPI therapy
  • Confirmed pathological reflux on 24 hour pH testing
  • Hiatus hernia and/or oesophagitis
  • Patients with Barrett’s oesophagus and on-going reflux symptoms

Weaker indications for surgery include

  • Sore throat or burning in the throat in people with confirmed acid reflux
  • Cough with confirmed acid reflux
  • Hoarse voice with confirmed acid reflux

In these last categories, only 7 out of 10 people are thought to respond.

If you suffer, get professional advice and seek a second opinion before choosing to have surgery.

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