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Do I have to undergo surgery for reflux disorder?

Dr Sanjiv Saigal
Consultant Gastroenterologist,
Sir Ganga Ram Hospital,
New Delhi

Q: I am 20 years old and suffering from acidity and heartburn for the last many months and there is also bitterness in my tongue. Two days back, I consulted a gastroenterologist who advised for endoscopy, blood tests, urine test and chest x-ray. While all these tests were normal, the endoscopy showed some abnormalities. The results were interpreted as Grade 3 reflux oesophagitis with gastric mucosal prolapse. What does the result actually mean? The doctor has advised me to undergo a laparoscopic surgery. Is surgery the only option or are there any chances of curing it by tablets? Are any more tests required? What will be the complications, if left untreated? What will be the side effects of this surgery? I am very worried and want to avoid the surgery. Please suggest.

A:From the details that you have provided, it is clear that you are suffering from gastro esophageal reflux disease (GERD). I must tell you that majority of patients of GERD are treated with Medications and life style modifications. Only those who do not respond are actually advised surgical treatment. So in the first instance, you should take a proper course of medical treatment. This would include:1. Acid suppressants like omeprazole, pantoprazole, etc.2. Prokinetics such as domperidone 3. Life style modifications such as avoiding fatty and spicy meals, not lying down within an hour of your meal, avoiding smoking and alcohol, etc. If GERD is left untreated, then one can get complications in the long run such as strictures, ulcerations, bleeding etc. If you continue to have symptoms despite adequate medical treatment, then you may need surgical treatment.