I have been suffering from GERD for many years and my medication just doesn’t seem to do the trick. If I have chronic acid reflux, at what point should I consider surgery?
If I have chronic acid reflux, should I consider surgery?
Although there are quite a few reasons why someone would consider surgery for acid reflux, the vast majority of the procedures in the United States are performed for the following reason: “failure of medical therapy.” This means that the maximum dose of reflux medication, presumably along with lifestyle changes that can improve GERD symptoms, has failed to provide relief a level of satisfaction for that particular individual.
The acknowledgement that a particular treatment has failed can sometimes be difficult to recognize, define, and admit on the part of the treating physician AND the patient. This is true with anything in life. If we embark down a path expecting a particular reward, we often push and push and continue down the same path before finally recognizing that it is the wrong one. No one wants to admit failure in anything, including treatment for an illness. As a result, a change in course is delayed, resulting in needless suffering. This phenomenon is a significant problem when it comes to the treatment of GERD.
Proton pump inhibitors: The first line of defense
In most cases, GERD is diagnosed when a patient’s symptoms are relieved by medication (right or wrong, symptoms are usually the measuring stick). The initial treatment plan usually includes acid suppressive medication (usually proton pump inhibitors, PPIs) and recommended changes in lifestyle. This approach will either work or it will not. Understand that the end goal is symptom relief as defined by the satisfaction of the patient – not by the physician or anyone else.
If a patient is on a maximum dose of reflux medication (usually defined as PPIs twice a day) and symptoms persist, even with reasonable changes in diet and lifestyle, medical therapy has failed – pure and simple. Far too often, symptom relief is defined by the treating physician, who pushes on with medication after medication, PPI after PPI, while the patient continues to suffer. If medical therapy provides you with acceptable symptom relief, that is wonderful. What is not wonderful is continuing a failed treatment and not offering something different. If medical therapy fails, and chronic acid reflux seems apparent, it’s time to explore the surgical option.
When reflux medication fails, consider surgery for chronic acid reflux
Surgery for acid reflux is usually considered much later than it should be, well after the point of obvious medical failure. If you continue to suffer after treatment with PPIs, at least learn about your options. You’re not committing to anything by doing research. Understanding your options – and the pros and cons of each – will enable you, the patient, to make an educated choice, and hopefully, head down a path towards relief.