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Return to Treating Gastroesophageal Reflux Disease (GERD) Overview

More on Treating Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux and Motility Disorders Laboratory

Treating Gastroesophageal Reflux Disease (GERD)

For appointments and information, please call (212) 746-5130

In most cases, GERD is a chronic condition that people live with for the rest of their lives. Patients either need to take medication lifelong or undergo surgery. Diet and lifestyle modifications may be necessary for patients with reflux.

Medical Treatment

Medications designed to suppress the production of excess acid are typically the main option for the management of individuals with reflux. Over the counter medications include antacids, H2 blockers, and proton pump inhibitors. Proton pump inhibitors are the most effective medical management for GERD. Some patients can live their whole life with minimal symptoms on these medications. The drawbacks are that daily usage is required lifelong.

Medications are less effective when a large hiatal hernia, regurgitation, aspiration, cough and voice problems are present. In addition, they can have side-effects including decreased calcium absorption, which can cause bone problems, particularly in post-menopausal women.

Surgical Treatment

Certain patients with GERD may be appropriate candidates for surgical treatment using a procedure called Nissen fundoplication (also called anti-reflux surgery). This procedure stops reflux of stomach contents by tightening the valve located between the stomach and the esophagus (lower esophageal sphincter). Unlike medications that only provide pain relief from heartburn, surgery can cure GERD for most patients.

Surgery should be recommended for:

  • Patients who are young, to avoid the side effects and diminishing effectiveness of taking medications for many decades
  • Post-menopausal women, for whom some anti-GERD medications raise the risk of osteoporosis
  • Individuals with voice or respiratory problems, including hoarseness, cough or asthma due to reflux
  • Patients who have a large hiatal or paraesophageal hernias that make it difficult to eat.

Nissen fundoplication has been the standard surgery for GERD for nearly 50 years, and is performed by skilled surgeons at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. This procedure is done laparoscopically using a minimally invasive technique with 5 small incisions typically between 5mm and 10mm in length. Because of this approach most patients are eating a regular diet within a day of surgery and home within a day of surgery.

Nissen fundoplication surgery creates a 360-degree wrap around the esophagus. This procedure is very effective for treating reflux, and helps patients avoid the need for life-long use of anti-reflux medications. Compared to traditional open surgery, laparoscopic fundoplication offers patients:

  • Faster recovery (usually only one night in the hospital)
  • Significantly less pain because the incisions are so small
  • Minimal scarring
  • Regular diet (except heavy breads and steaks 1 day after surgery)
  • Back to regular activity and work within days of surgery

When performed by a surgeon with much experience in this minimally invasive technique, laparoscopic fundoplication offers the same high success rate for treating GERD as achieved through the traditional open fundoplication procedure. Our team includes some of the most experienced surgeons in the world at performing laparoscopic fundoplication.

Contact

Gastroesophageal Motility Disorders Facility
Directions
(212) 746-5130
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        Fax: (212) 746-8753
        Address: 525 E. 68th Street
        Starr 8
        New York, NY 10065
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