There are several indications in which surgery is a must.

1. Chronic heartburn continues to disrupt your every day routines despite your lifestyle modifications or medications.
    
2. Documentation of Acid Reflux through diagnostic testing (upper endoscopy, 24 hr. pH, and manometry).
    
3. Development of complications associated with GERD (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 belly.
   
   The post-op hospital stay is 1-3 days and approx. 1 week out of work but no lifting greater than 10 lbs. for one month.  After the surgery, there are several very important dietary guidelines to follow:  No Carbonated Beverages and a full liquid diet for 10-14 days. This includes milk products (like ice cream, yogurt, and milk shakes) and thick soups (cream of …) without the chunks. The doctor will advance the diet as the swelling around the new "valve" decreases.