There are several indication in which surgery is a must:

1. Chronic hearburn continues to disrupt your every day routine despite your lifestyle modifications or medications.
2. Documentation of acid reflux through diagnostic testing (upper endoscopy, 24 hour ph testing, and manometry).
3. Development of complications associated with G.E.R.D., such as stricture, chronic esophagitis, Barrett's esophagitis, bleeding, or aspiration).

The surgery itself involves constructing a new "valve" between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest point of the esophagus.  In most cases, the surgery is done laparoscopically with 5-7 tiny incisions in the abdomen.  This allows the video camera and the instruments to be inserted into the abdomen.

The post-op hospital stay is approximately 1-3 days with about one week out of work.  Patients are not allowed to lift greater than ten pounds for at least one month.  After the surgery, there are several very important dietary guidelines to follow:  NO carbonated beverages and full liquid diet for 10-14 days.  This includes milk products (ice cream, yogurt, and milk shakes) and thick soups (cream of chicken, etc.) without the chunks.  The doctor will advance your diet as swelling around the new valve decreases.