Should I consider surgery after years of GERD treatment at 55?

Question

Hello doctor,

I am a 55-year-old male and have been dealing with gastroesophageal reflux disease (GERD) for many years.

I am taking proton pump inhibitors (PPIs), and they help. However, if I miss even one dose, my reflux returns with throat burning, and I wake up at night feeling acid come up into my throat.

I had an upper endoscopy (EGD), which showed chronic reflux-related changes but nothing concerning. Still, I am getting tired of relying on medications and following strict food restrictions.

At what point do people with long-term GERD start seriously considering surgery or other procedures instead of staying on medications indefinitely?
Has anyone who chose that route regretted it, or would you recommend it?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

According to your medical history, it is likely that you suffer from chronic acid peptic disease with GERD (gastroesophageal reflux disease). You have mentioned that you have undergone upper gastrointestinal endoscopy (EGD), which revealed chronic reflux changes.

I wish to know if you had any other findings, specifically the following:

Antral gastritis (inflammation of the lower part of the stomach).
Gastric erosions (when the mucous membrane lining the stomach becomes inflamed).
A lax gastroesophageal junction (weakened gastroesophageal junction).
Hiatal or paraesophageal hernia (when the top of your stomach bulges through an opening in your diaphragm).
Whether a rapid urease test (RUT) was performed and, if so, what the result was?
Any gastric or esophageal ulcers.
Whether biopsies were taken from the stomach or the esophagus.

Moreover, please let me know about the following:

Do you have any other comorbidities?
Do you suffer from any other comorbidities?
Do you take any other medications other than PPIs (proton-pump inhibitors)?
Are you a smoker?
Are you an alcoholic?
What is your body habitus (obese, lean, or thin)?
What was your gastroenterologist's opinion?

Based on the above information, appropriate therapeutic options can be considered.

Nowadays, many endoscopic therapeutic procedures are available for the treatment of GERD. Laparoscopic and other minimally invasive anti-reflux surgeries are also effective treatment options for selected patients.

I advise you to consult again with your gastroenterologist for a proper assessment and recommendation concerning the best course of action, depending on your clinical findings and investigations.

I hope I have been able to provide you with the right answers.

If there is anything else you would like to ask, please feel free to do so.

Thank you.