GERD/Reflux Disease

General and gastrointestinal surgeons at BWFH offer a range of procedures for diagnosing GERD:

• Upper GI (gastrointestinal) series (barium swallow)
• Esophagogastroduodenoscopy (EGD or upper endoscopy)
• Bernstein test
• Esophageal manometry
• pH monitoring

Watch this video of an upper endoscopy (EGD) used to diagnose GERD/Reflux Disease.

Treatment for GERD ranges from lifestyle changes to medications to surgery. The goal of treatment is to find the cause, so you can prevent it from recurring.

Surgical Treatment

Surgery should be considered for patients who:

• Have not had medication success
• Do not want to take chronic medication
• Have symptoms attributable to a large hiatal hernia
• Have complications of GERD (stricture, Barrett's esophagus grade III or IV esophagitis)
• Have atypical symptoms (asthma, hoarseness, cough, chest pain, aspiration) and documented reflux

Minimally Invasive Surgery

• Nissen fundoplication repairs the hiatal hernia and tightens the lower esophageal sphincter (LES) and helps to decrease acid from coming up from the stomach into the esophagus. Fundoplication is usually performed as a laparoscopic procedure. Although a Nissen fundoplication is the most common form of fundoplication, other types of fundoplication are also sometimes performed based on surgical assessment and recommendation.
• Linx procedure is a minimally invasive operation that is indicated for a small percentage of patients with GERD and no hernia where a device is placed around the esophagus to prevent reflux.
• Transoral incisionless fundoplication (TIF), a transoral (through the mouth) procedure in which the EsophyX device is used to wrap around the esophagus and create a fold. This is then repeated several times to create a tight valve to prevent stomach contents from flowing back up into the esophagus.