Functional Heartburn and Heartburn Pills

Louise from Houston asked us this interesting question: When pH, motility and gastric emptying tests come back negative, yet there is still heartburn and only partial response to a PPI, what does one do?  especially if one's eGFR is in the 40's.  Do you save...

Robotic Hiatal Hernia Repair for Severe Heartburn

Robotic Hiatal Hernia Repair for Severe Heartburn

Question of the week from Reginald in Houston: I had surgery for hiatal hernia in 2014. I re-experienced reflux after 15 months and began taking Omeprazole. This seemed to work. In the last 4 months other symptoms have begun and my surgeon had me go...

Heartburn Treatment Options in Houston

Heartburn Treatment Options in Houston

Question of the week from Grace in Houston: I have been on heartburn medications for 19 years since my gallbladder surgery in 2000. What else can help control my GERD? Dear Grace, Heartburn pills are neither the most effective nor the only treatment option for GERD. Indeed,...

Gastric Diverticulum and Heartburn Treatment

53-year-old male presents for evaluation of severe acid reflux related symptoms poorly responsive to medical treatment. His symptoms include heartburn and food regurgitation. Upper endoscopy revealed large hiatal hernia, distal esophagitis, and a posterior gastric fundus diverticulum measuring around 5 by 5 cm. The gastric...

Nissen Fundoplication Durability

Praveen from Houston Asked us this question this past week: I’m 32-year-old and I have been suffering from GERD for almost 2 years now. I am considering the Nissen fundoplication to control my acid reflux. I don’t want to have multiple major surgeries, especially when...

Slipped Nissen Fundoplication

Slipped Nissen Fundoplication: Why Do We Still See It?

Nissen fundoplication surgery, when PROPERLY done, is the most reliable, safest, and most effective treatment for GERD. Any fundoplication surgery is performed with a concomitant hiatal hernia repair. The purpose of a hiatal hernia repair is not to simply close the hiatal opening, but rather...

Does Nissen Fundoplication Affect the Magenstrasse

Does Nissen Fundoplication Affect the Magenstrasse?

In his seminal paper, “A Stomach Road or Magenstrasse for Gastric Emptying”, James Brasseur concludes that the coordination of contractile waves between gastric fundus and antrum determines the magnitude of the Magenstrasse. Surgical manipulation of gastric fundus in the form of Nissen fundoplication alters antral...

Laparoscopic vs Open GERD Surgery

I read with great interest the newly published article titled “Comparative Analysis of Perioperative Outcomes and Costs Between Laparoscopic and Open Anti-reflux Surgery” in the journal of the American College of Surgeons by Patti el al. This is a retrospective study based on the National...