I am 38, female. Are there surgical options to manage my GERD?

Question

Hello doctor,

I am a 38-year-old female, and I have been suffering from GERD for almost four years. However, over the past six months, it has become very difficult to manage. I take Pantoprazole 40 mg daily before breakfast, but I still wake up at night three to four times with a burning sensation in my chest and a sour taste in my mouth.

Sometimes, I feel like food is getting stuck in the middle of my chest after eating, and I have had two episodes of choking at night, which scared me. My gastroenterologist performed an endoscopy eight months ago and found grade B esophagitis and a small hiatal hernia.

I have been avoiding spicy food, coffee, and lying down after meals, but nothing is giving me complete relief. I am also taking calcium supplements for osteopenia, and my orthopedic doctor mentioned that long-term PPI use can worsen bone health, which concerns me.

Recently, I have noticed that my voice has become hoarse in the morning, and my ENT specialist said it could be due to GERD affecting my throat. My weight is 180 pounds, and I understand that losing weight can help, but I also have thyroid issues, which make it difficult.

Are there any surgical options for GERD with a hiatal hernia, or stronger treatments that can finally provide proper relief?

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

Based on your description, you have GERD (gastroesophageal reflux disease) with insufficient control despite Pantoprazole therapy and a known hiatal hernia. Night symptoms, regurgitation, dysphagia, and hoarseness suggest significant reflux, likely with extra-esophageal manifestations.

In such cases, medical therapy is first optimized (sometimes by increasing the dose, adjusting the regimen, or adding additional medications). If symptoms persist, further diagnostic evaluation and surgical treatment may be considered (as a last-line option).

Regarding PPIs (proton pump inhibitors): with long-term use, there may be some risk to bone health, but at this stage, the priority is adequate reflux control.

To better help you, I would need answers to a few questions:

Have you tried taking Pantoprazole twice daily along with any additional medications?
How often do you experience difficulty swallowing food?
Do you have a night cough or episodes of choking, or feeling short of breath?
Do you have any other chronic conditions (especially thyroid disease or respiratory diseases)?

In order to provide more precise recommendations, I need answers to the questions asked above. After that, it will be possible to determine the further treatment strategy and the need for additional investigations or specialist consultations.

Hope I have addressed all of your queries and concerns. Do follow up whenever needed.

Thank you.