Dear Dr. Roach: I am an 81-year-old retired nurse. I have had GERD for as long as I can remember. My surgeon measured my hiatal hernia, and he said it was 5
cm. I am taking Nexium, 40 mg. Due to my age, I do not want to have any kind of surgery. My only problem is this GERD. I recently heard on TV that there is a surgery to repair a hiatal hernia. It is done via endoscopy. Do you know anything about this? D.E.
Answer: Although most people with GERD, with or without a hiatal hernia, do well with lifestyle modification and medications, surgery has long been an option for people with severe symptoms or those who do not want to (or cant) take medications. The procedure is called a fundoplication. It ties part of the stomach around the esophagus, preventing both reflux (acid going into the esophagus) and the stomach from going through the hiatal hernia into the chest.
A similar procedure can be done now by endoscopy. However, it isnt right for everybody. It is not indicated for people with severe inflammation in the esophagus, including a Barretts esophagus. After the procedure, most people are unable to belch or vomit. This may not sound bad, but it can lead to bloating and distension.
This is a new procedure, and its not clear yet how well it will work in the long run: At six months, about 70 percent of people who had the procedure were satisfied with the results.
