Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 43: A 45-Year-Old Gentleman Comes To You Following A Laparoscopic Nissen Fundoplication 5 Years Ago. He Now Has Recurrent Gerd Symptoms. How Common Is This? (continued)

The decision to send a patient to surgery for GERD is not straightforward. If the patient is intolerant of or allergic to proton pump inhibitors (PPIs), the decision is relatively easy for me. In patients who are on high doses of PPI, those with reflux-related lung disease, those who cannot or choose not to afford PPIs, and those with regurgitation due to non-acid reflux surgery, the alternative is often considered. In making this decision, the patient must weigh the risks and benefits of surgery versus long-term medical therapy and consider the possibility of relapse even if surgery is…