Why Get Surgery For Acid Reflux?

In this video, Dr. Erik Lough explains why surgery may be a necessary option for patients suffering from acid reflux. He details how the condition occurs when the lower esophagus muscles fail to close properly, allowing stomach acid to irritate the esophagus, often leading to painful symptoms like heartburn and regurgitation. While many people manage acid reflux with medications, Dr. Lough discusses when surgery becomes the preferred solution, such as when medications no longer work, symptoms persist, or patients wish to eliminate their dependence on daily drugs. He also highlights the role of a hiatal hernia in exacerbating reflux and how addressing it can significantly improve symptoms. Dr. Lough emphasizes that if you’re struggling with chronic acid reflux, surgery could offer a long-term solution to improve your quality of life and eliminate the need for ongoing medication.

TRANSCRIPT

Hi, I’m Dr. Erik Lough, and I’m here to answer common questions that patients ask me about general and weight-loss surgery. Today, I’ll be addressing the question: Why get surgery for acid reflux?

Acid reflux occurs when the muscles in the lower esophagus fail to close properly, allowing stomach acid and juices to flow backward into the esophagus. This often causes heartburn—that rising, burning sensation in your chest. For some people, it can be worse, especially at night when acid regurgitates into the throat or airway. This can lead to excessive swallowing, coughing, and, in severe cases, choking.

Long-term acid reflux can result in inflammation of the esophagus, known as esophagitis. Chronic esophagitis, in turn, is a risk factor for esophageal cancer.

Many people treat acid reflux with antacids like Tums or acid blockers like Nexium or Pepcid. If medication works for you, that’s great—you likely don’t need surgery yet.

The goals of acid reflux surgery are twofold: to free patients from the symptoms of acid reflux and to eliminate their dependence on medications. As a surgeon, I recommend surgery for several reasons:

  1. Medication no longer works.
    Some patients have been on omeprazole or similar medications for over a decade. Over time, they find themselves needing higher doses—sometimes taking it twice a day—and still relying on Tums in between doses.
  2. Symptoms persist despite medication.
    Even with medication, some patients experience severe regurgitation, can’t eat after 6 p.m., sleep propped up on multiple pillows, or suffer from constant coughing and throat clearing due to acid irritating their vocal cords. Surgery can stop regurgitation and improve their quality of life.
  3. Desire to avoid lifelong medication.
    Some people don’t want to depend on daily medication indefinitely. They say, “If I miss a dose, I pay the price. Do I have to live like this forever?” Surgery can eliminate the need for ongoing medication and its potential side effects.
  4. Presence of a hiatal hernia.
    A hiatal hernia occurs when part of the stomach pushes up through the diaphragm, exacerbating reflux. While not everyone with reflux has a hiatal hernia, nearly everyone with a hiatal hernia experiences reflux. I’ll cover hiatal hernias in a separate video, but for now, just know that treating a hiatal hernia can significantly reduce reflux symptoms.

If you’re struggling with acid reflux and want to explore your options, schedule a consultation with me, Dr. Erik Lough, today. Together, we can find the solution that’s right for you.