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 they are so operator dependent and if not done properly can be disastrous. How long does a properly performed Nissen last?
Dear Praveen,
Your question is quite relevant. It is one of the most common questions I get asked at Houston Heartburn and reflux Center. There is a general misconception among gastroenterologists and primary care physicians that Nissen fundoplication acid control effects do not last, and patients end up with recurrent acid reflux symptoms. In reality, properly performed Nissen fundoplication in patients your age group are likely to enjoy the rest of their life free of acid reflux disease. A properly performed Nissen fundoplication surgery is key, and you are absolutely right: Nissen fundoplication surgery is operator dependent. Indeed, the whole process of GERD management starting with initial diagnosis is operator dependent. For this reason, at Houston Heartburn and Reflux Center, I personally perform GERD work up and accurately select patients for Nissen fundoplication. A comprehensive GERD work-up, accurate patient selection and PROPERLY performed Nissen fundoplication invariably result in effective and durable outcomes.
Comprehensive GERD work-up starts with a detailed initial consultation. During this initial encounter, an experienced acid reflux specialist goes over patient symptoms, exacerbating factors and response to medications. Subsequently, a number of tests like upper endoscopy, ambulatory pH testing, esophageal manometry and UGI contrast are ordered to rule in or rule out GERD diagnosis, hiatal hernia, Barrett’s esophagus, peptic ulcer disease, esophageal stricture, esophageal diverticula, achalasia, gastroparesis… Once the diagnosis of GERD is made, a tailored treatment plan is formulated that best suits patient particular condition.
If Nissen fundoplication is indicated, surgery must be meticulously performed by an expert acid reflux surgeon to yield good outcome. Fundoplication surgery requires experience and mastery of advanced surgical skills. When properly done GERD patients enjoy durable and reliable acid reflux symptom resolution.