If you rely on medication to manage persistent acid reflux, you may wonder if you’ll need to take it indefinitely. For some people with gastro-oesophageal reflux disease (GORD), surgery can provide longer-term symptom control and reduce the need for regular medication.
This guide looks at when medication may be enough and when surgery could help instead.
How does long-term medication help acid reflux?
GORD develops when stomach acid repeatedly flows back into your oesophagus, the tube that carries food from your mouth to your stomach. This can cause heartburn or an unpleasant taste in your mouth. Some people also experience discomfort when swallowing.
Medicines called proton pump inhibitors (PPIs) are often prescribed for GORD. They reduce the amount of acid your stomach produces. This can ease your symptoms and allow inflammation in your oesophagus to heal.
PPIs can be taken over the longer term if they’re helping to manage your symptoms, and many people use them without significant problems. However, some people experience side effects such as headaches or digestive changes. Longer-term use may also need monitoring because PPIs can sometimes affect magnesium or vitamin B12 levels.
Your doctor will usually review your medication from time to time to make sure it’s still helping and that the dose suits your needs. If side effects are affecting you, or you’re concerned about relying on medication, a specialist can help you explore the alternatives. Speak to your doctor before making any changes to prescribed treatment.
Can acid reflux surgery help you stop taking medication?
For some people with ongoing GORD, acid reflux surgery can provide longer-lasting relief and reduce the need for regular medication. You may be able to stop taking medication completely after surgery, although some people still need it occasionally. Others may need to continue taking it regularly.
Medication works by making your stomach contents less acidic. Surgery works differently by helping the valve between your stomach and oesophagus close more effectively. This can prevent stomach contents from flowing upwards.
Everyone’s experience of GORD is different, so the results of surgery can vary. Your specialist will consider what’s causing your reflux before discussing which procedure may suit you. The main aim is to give you lasting relief and help you feel more comfortable in everyday life.
When might surgery be considered for GORD?
If GORD continues to affect your comfort or everyday routine, you may want to explore options beyond medication.
Surgery may be considered if tests confirm GORD and:
- Your symptoms continue despite medication and lifestyle changes
- Your symptoms return when you reduce or stop medication
- Food or acid continues to come back up into your throat despite taking PPIs
- Your medication is causing side effects that affect you
- You have a hiatus hernia (where part of your stomach pushes up through the diaphragm and into your chest) contributing to your reflux
- You’d like to explore an alternative to long-term medication after understanding the potential benefits and risks
Thinking about surgery doesn’t mean you’re committing to an operation. Your symptoms will first need to be assessed carefully, as problems that don’t improve with PPIs can sometimes have another cause.
For some people, medication will continue to be the most suitable way to manage GORD. Your specialist will listen to what matters to you and help you understand each option, giving you the information you need to make a decision you feel comfortable with.
How does acid reflux surgery work?
A ring of muscle called the lower oesophageal sphincter sits between your oesophagus and stomach. It acts like a valve, opening when you swallow and closing afterwards. If it’s weak or relaxes at the wrong time, stomach contents can flow back into your oesophagus.
Acid reflux surgery helps this valve close more effectively. The two main types of surgery are LINX, which uses a flexible ring of magnetic beads, and fundoplication, which uses the upper part of your stomach to support the valve.
Both procedures can be performed through keyhole surgery.
LINX surgery
During LINX surgery, the magnetic ring is placed around the lower end of your oesophagus. The beads separate when you swallow, allowing food to pass into your stomach. They then come together again to help prevent reflux.
Tests will confirm if LINX may be suitable for you. Some people experience difficulty swallowing afterwards and, occasionally, the device needs to be removed.
Fundoplication
During fundoplication, your surgeon wraps the upper part of your stomach around the lower oesophagus. This helps the valve close properly and prevents stomach contents from flowing upwards. They can usually repair a hiatus hernia during the same operation.
Fundoplication can provide longer-term relief, although you may experience bloating or difficulty swallowing during recovery. Some people also find it harder to belch or vomit afterwards. Your specialist will explain what to expect before you decide about treatment.
How are you assessed for acid reflux surgery?
Your assessment will begin with a discussion about your symptoms and how they affect your everyday life. Your consultant will also review the treatment you’ve tried so far, including your current medication.
Depending on your symptoms, you may need:
- An upper gastrointestinal endoscopy, where a thin, flexible camera is passed through your mouth to look inside your oesophagus and stomach
- Reflux monitoring, which uses a small device to record how often acid or other stomach contents travel into your oesophagus
- A swallowing test called oesophageal manometry, where a thin tube measures how well the muscles in your oesophagus are working
- A scan or specialist X-ray to check for a hiatus hernia
These investigations help confirm if reflux is causing your symptoms. They can also show how well your oesophagus is working, which helps your consultant recommend a suitable treatment.
What results can you expect after surgery?
Many people have fewer reflux symptoms after surgery and can reduce or stop their medication.
You may experience temporary difficulty swallowing or bloating as you recover. Surgery also carries possible risks such as bleeding or infection. Your consultant will talk you through the possible benefits and risks, giving you time to ask questions before deciding if surgery feels right for you.
Explore your acid reflux treatment options with Mr Khanna
Living with reflux that only stays under control while taking medication can feel frustrating. If you’re wondering what else may help, a specialist assessment can give you a clearer understanding of your options.
Mr Achal Khanna is an experienced upper gastrointestinal surgeon who offers LINX and fundoplication surgery in Milton Keynes. He’ll listen to how your symptoms are affecting you and look at the treatment you’ve already tried. He can then explain if surgery may be suitable and help you feel confident about your next step.
Contact Mr Khanna today to arrange a consultation and discuss the next step in managing your reflux.