All about anti-reflux surgery

Anti-reflux surgery is a treatment option for people suffering from chronic gastroesophageal reflux disease (GERD) when lifestyle changes and medications fail to provide relief. GERD occurs when stomach acid frequently flows back into the oesophagus, causing symptoms such as heartburn, regurgitation, chest discomfort, and sometimes damage to the oesophageal lining. Over time, untreated reflux can lead to complications including strictures or Barrett’s oesophagus.

The most common surgical procedure for GERD is fundoplication. In this operation, the upper part of the stomach (the fundus) is wrapped around the lower oesophagus to strengthen the lower oesophageal sphincter (LES). This reinforcement helps prevent acid from flowing backward while still allowing food to pass into the stomach. Fundoplication is typically performed laparoscopically, using small incisions and specialised instruments, which generally results in shorter recovery times and less postoperative pain compared to open surgery.

Another newer option is magnetic sphincter augmentation, where a ring of small magnetic beads is placed around the LES. The device strengthens the barrier against reflux while still opening to allow swallowing. This approach is less invasive and has gained popularity in selected patients.

Candidates for anti-reflux surgery are usually those with severe, persistent symptoms, those who cannot tolerate medications, or individuals who prefer a long-term solution over lifelong drug therapy. Preoperative evaluation often includes endoscopy, oesophageal manometry, and pH monitoring to confirm the diagnosis and assess suitability.

While anti-reflux surgery can be highly effective, it is not without risks. Potential complications include difficulty swallowing, gas bloating, and, in rare cases, recurrence of reflux. Careful patient selection and experienced surgical care are essential to achieving optimal outcomes.