Chronic acid reflux that doesn't respond well to medication can sometimes be traced to a hiatal hernia and may benefit from surgery. Dr. Pavan Addala, Surgical Gastroenterologist at Medicover Hospitals, Secunderabad, treats chronic GERD and hiatal hernia with antireflux surgery, including laparoscopic techniques.
GERD (gastroesophageal reflux disease) happens when stomach acid regularly flows back into the esophagus, usually because the valve between the stomach and esophagus isn't working properly. A hiatal hernia, where part of the stomach pushes up through the diaphragm into the chest, often contributes to this by weakening that valve mechanism. The two frequently go together, though not always, and distinguishing how much each is contributing matters for treatment planning.
Occasional heartburn after a heavy meal is normal. Frequent symptoms, several times a week over an extended period, are what typically warrant proper evaluation.
Diagnosis typically involves an upper endoscopy to examine the esophagus directly and check for damage or Barrett's esophagus (a change associated with long-standing reflux), and sometimes additional tests such as pH monitoring (to measure acid exposure over 24 hours) or esophageal manometry, depending on the specific symptoms and whether surgery is being considered.
Most GERD is managed first with lifestyle changes (weight management, avoiding trigger foods, not lying down soon after eating) and medication, typically acid-reducing drugs. Many people manage well long-term this way. It's worth knowing that long-term acid-reducing medication use is generally considered safe but is a genuine, ongoing commitment some patients would prefer to avoid, which is part of what makes surgery a reasonable alternative to discuss for appropriate candidates.
Surgery, typically antireflux surgery such as a laparoscopic fundoplication (wrapping part of the stomach around the lower esophagus to reinforce the valve), becomes relevant when symptoms persist despite medication, when a significant hiatal hernia is present, or when a patient prefers not to stay on long-term medication. Dr. Addala offers laparoscopic antireflux surgery for appropriate cases. For suitable cases, this may also be performed using a robotic-assisted approach.
Recovery after laparoscopic fundoplication typically involves a hospital stay of one to two days, with a temporary soft-food diet for a couple of weeks while the surgical site heals, before gradually returning to a normal diet. Most patients return to regular activity within two to four weeks.
Deciding between continuing medication long-term and having antireflux surgery is a significant, personal decision. A second opinion, especially one that reviews your pH monitoring and manometry results, can help clarify which path genuinely fits your situation.
Book a second-opinion consultation →Occasional acid reflux is normal and common. GERD is diagnosed when reflux is frequent, persistent, or causing complications, a difference in degree and pattern, not just terminology.
Most people manage GERD with medication and lifestyle changes. Surgery is considered when symptoms don't respond well to medication, when a significant hiatal hernia is present, or based on personal preference regarding long-term medication use.
Difficulty swallowing has several possible causes, including GERD, but also achalasia and other conditions that need to be distinguished through proper evaluation.
Generally considered safe for long-term use, though like any medication it has some associated considerations worth discussing with your doctor, which is part of why some patients explore surgical alternatives.
Varies by hospital stay and case complexity. Most insurance plans cover antireflux surgery when medically indicated — confirm specifics with your insurer.
Book a consultation so it can be properly evaluated, especially if symptoms are frequent, not responding to over-the-counter treatment, or accompanied by difficulty swallowing.
Chronic heartburn that medication isn't fully controlling is worth a proper evaluation, not indefinite over-the-counter management.
