Gastroesophageal Reflux Disease

Proton pump inhibitor medications are the first line treatment GERD.  These work by powerfully reducing the amount of acid the stomach produces.  However, they do nothing to stop stomach contents from refluxing into the esophagus where they can still cause symptoms even though they are less acidic.  Although there is conflicting data, some studies have suggested there may be negative consequences to taking proton pump inhibitors long term.  The laparoscopic Nissen fundoplication is a well established procedure for the treatment of GERD that has been successfully employed since the early 1990s.  It involves wrapping part of the stomach around the end of the esophagus.  The side effects are usually temporary trouble swallowing and belching as well as sometimes bloating.  A device called LINX has been in use for about 1o years and has less side effects than the Nissen and consists of a ring of magnetic beads that augment the lower esophageal sphincter.  Despite positive study results, most insurance has refused to pay for LINX so patients often have to pay for the device themselves.



When the lower esophageal sphincter is weak, stomach contents can flow back into the esophagus.



LINX augments the lower esophageal sphincter to allow less reflux from the stomach into the esophagus.



A Nissen fundoplication is a wrap of the fundus of the stomach around the lower esophagus.