Watch more on
on YouTube
Do I Need Surgery for Reflux?
Understanding When GORD Requires Surgical Treatment
Do I need surgery for reflux?
Reflux, also known as gastro-oesophageal reflux disease (GORD), is a very common condition. Most people will experience some degree of reflux during their lifetime.
However, only a small proportion of patients require surgery.
Â
In most cases, reflux can be managed with lifestyle changes and medication.
Â
Surgery is typically considered when reflux becomes persistent, severe, or complicated.
When is reflux considered serious?
Reflux may require further investigation or treatment when it becomes pathological reflux, meaning it is no longer adequately controlled.
Surgery may be considered if:
- symptoms are not controlled with medication
- reflux causes complications
- there is a significant impact on quality of life
- patients prefer to avoid long-term medication
In these situations, specialist assessment is important to determine the most appropriate treatment.
What is reflux surgery?
The most common surgical treatment for reflux is called a fundoplication.
This procedure reinforces the valve between the oesophagus and stomach, helping to prevent acid from flowing back into the oesophagus.
Fundoplication may be performed as:
- a partial wrap
- a full 360° wrap
It is usually carried out using laparoscopic or robotic minimally invasive techniques.
When is reflux considered serious?
Reflux may require further investigation or treatment when it becomes pathological reflux, meaning it is no longer adequately controlled.
Surgery may be considered if:
- symptoms are not controlled with medication
- reflux causes complications
- there is a significant impact on quality of life
- patients prefer to avoid long-term medication
In these situations, specialist assessment is important to determine the most appropriate treatment.
Does surgery cure reflux?
It is important to understand that reflux surgery does not cure the underlying condition.
Instead, it works by preventing acid from reaching the oesophagus
Â
This helps reduce symptoms such as:
- heartburn
- regurgitation
- chest discomfort
- acid taste in the mouth
While outcomes are generally good, no operation is completely guaranteed to eliminate symptoms in all cases.
What happens if reflux returns after surgery?
In some patients, symptoms may return after surgery.
These may include:
- recurrence of reflux
- difficulty swallowing (dysphagia)
- persistent chest discomfort
- dental erosion
If this occurs, further investigations are required.
How is reflux assessed after surgery?
To confirm whether reflux has returned, patients may undergo:
- endoscopy
- pH monitoring (to measure acid exposure)
- oesophageal manometry (to assess muscle function)
These tests help determine whether symptoms are due to reflux and guide further treatment.
What is revision reflux surgery?
If reflux is confirmed and not controlled with medication, revision reflux surgery may be considered.
This involves correcting or adjusting the previous operation and is typically performed using robotic or laparoscopic techniques.
In rare cases, if there is significant scarring from previous surgery, an open procedure may be required.
When should you see a specialist?
You should consider specialist assessment if you experience:
- persistent reflux despite medication
- difficulty swallowing
- unexplained chest or upper abdominal pain
- symptoms affecting daily life
- recurrence of symptoms after previous surgery
Early assessment helps ensure appropriate diagnosis and treatment.
Frequently asked questions
Do all reflux patients need surgery?
No. Most patients can be managed with medication and lifestyle measures. Surgery is only recommended in selected cases.
Is reflux surgery permanent?
Reflux surgery can provide long-term symptom control, but it does not cure the underlying condition and symptoms may recur in some patients.
Is robotic reflux surgery better?
Robotic surgery may offer advantages in certain cases, particularly for complex or revision procedures, but it is not required for every patient.
Can reflux come back after surgery?
Yes. Some patients may experience recurrence of symptoms, which may require further investigation or treatment.
Specialist reflux treatment in London Ash Rohatgi
Ash Rohatgi is a Consultant Upper Gastrointestinal Surgeon in London, specialising in laparoscopic and robotic surgery for conditions affecting the oesophagus and stomach.
His practice includes the assessment and treatment of:
- gastro-oesophageal reflux disease (GORD)
- hiatal hernia
- complications of reflux
- revision reflux surgery
Each patient undergoes a detailed evaluation to determine whether surgery is appropriate and which approach is most suitable.
