Treatment for GERD

Treatment for GERD
I’m looking for a treatment for GERD. I think I need surgery and really wanted to have the LINX procedure, but the results from my manometry didn’t allow me to be a candidate for LINX. The surgeon recommended the Toupet fundoplication. What can you tell me about this procedure? Is it an effective treatment for GERD?

Why LINX wasn’t an option

The LINX procedure is not indicated for patients who have abnormally weak function of the esophagus. This was determined by the results of the esophageal manometry study.

Learn more: Ten things you need to know about LINX

Other antireflux procedures

Other types of antireflux surgery are available in this setting. The most common procedure in general for resolving reflux is the laparoscopic Nissen fundoplication. With this procedure, the function of the lower esophageal sphincter, which is malfunctioning in reflux patients, is restored. This is accomplished by wrapping part of the stomach completely around the esophagus. The results of this procedure in properly selected patients are excellent. However, dysphagia (swallowing problems) can be a side effect and may be more pronounced in patients with weak esophageal function. For this reason there exists a modification of the Nissen procedure that seems to carry with it a lower risk of dysphagia, but still restores satisfactory function to the LES. This procedure is the Toupet fundoplication.

In the Toupet fundoplication, the stomach is only partially wrapped around the esophagus (about 270 degrees). Most recent studies suggest that this procedure stop reflux symptoms nearly as well as the Nissen and carries with it a lower risk of dysphagia. It is intuitive to think that if the stomach is not wrapped fully around the esophagus, side effects like dysphagia might be less. Studies suggest this. The Toupet’ fundoplication is used extensively in Europe with excellent results, as well as used in the United States in settings when there is compromised esophageal function. Most antireflux surgeons agree that once esophageal function is diminished to a certain degree (usually caused by longstanding reflux), that a Toupet should at least be considered.

Learn more: Gastroesophageal Reflux Disease (GERD): Procedures At-A-Glance

Recipe for relief in content ad

Do you have a question? We can help!

Fields marked with a * are required.

 
Ask your question using the form below. We try to respond to as many questions as possible via email, but some days we are simply overloaded. We also select one or two reader-submitted questions and post our response, so readers with similar concerns can benefit. If we select your question, you will be completely anonymous. So go ahead and ask your question! Then be sure to check back here for the answer: Your questions.

Providing your email allows us to respond directly to you.

If we think you should see a GERD expert, providing your zip code will allow us to locate someone near you.

This will allow us to provide a more personal and accurate response to your question. Don't know your stage? Click here to answer a few short questions and get personalized suggestions for creating your plan for relief.

Click here to determine your BMI.

Submitting this form will subscribe you to our mailing list. We will not share your email address and you can change your subscription settings at any time.