What's going on
Where your esophagus (food pipe) meets your stomach, there's a ring of muscle that works like a one-way valve. Food goes down, the valve closes, and stomach contents stay put.
In GERD (gastroesophageal reflux disease), that valve is weak or opens at the wrong times. Stomach acid and bile wash back up into the esophagus, which was never built to handle them. A hiatal hernia often makes it worse by pulling the valve out of position.
Signs it's reflux
Heartburn is the classic one, but reflux shows up in more ways than people expect:
- Burning behind the breastbone, especially after meals or when lying down
- Sour or bitter taste, or food coming back up (regurgitation)
- Chronic cough, hoarseness, or clearing your throat all the time
- Trouble sleeping flat, waking up choking or coughing
- Feeling like food sticks on the way down
What helps first
Most people start here, and many do well:
- Smaller meals, and nothing for 2 to 3 hours before bed
- Raising the head of the bed (blocks under the legs, not just more pillows)
- Cutting back on your personal triggers: often alcohol, coffee, chocolate, spicy or fatty foods
- Losing weight, which takes pressure off the stomach
- Acid-reducing medicines such as H2 blockers or proton pump inhibitors (PPIs)
If you're still having symptoms on medication, don't want to take pills for the rest of your life, or mostly have regurgitation (which acid pills don't stop), it's time to talk about fixing the valve.
When surgery makes sense
Before recommending an operation, I want proof that reflux is the problem. That usually means an upper endoscopy (a camera exam of the esophagus and stomach), and sometimes a pH test that measures acid exposure or a test of how your esophagus squeezes. Testing makes sure we pick the right fix.
What recovery looks like
A few small incisions. Many patients go home the same day or after one night.
Liquids, then soft foods while swelling settles. Walking right away. Most people are off reflux medication.
Back to desk work and normal activities. Food slowly goes back to normal.
Follow-up visits to make sure the repair is doing its job.
Common questions
Will I still need my reflux medication?
The goal is to get you off it. Most patients stop their acid medication after surgery. A few need a low dose later on, and we'll keep an eye on that together.
Can I still burp or throw up after surgery?
With modern, looser wraps and with LINX, most people can still burp. Some bloating is common in the first weeks and usually improves.
Isn't long-term medication safer than surgery?
For many people, medication is the right answer. But it treats acid, not the leaky valve, so regurgitation and cough often continue. Surgery is a reasonable choice when symptoms persist or you don't want lifelong pills.
How do I know if I'm a candidate?
Start with a consult. If you've had an endoscopy before, bring the report. If not, we'll set one up.
General information to help you understand your options. It isn't a diagnosis. The right plan for you comes from an in-person visit.