When to Stop PPIs after Nissen Fundoplication?

Acid reflux patients often wonder when does heartburn go away after Nissen fundoplication? The short answer is immediately.  Properly performed hiatal hernia repair and Nissen fundoplication restore a competent anti-reflux barrier. Consequently, acid reflux patients who have taken PPIs for years are consulted to stop all form of heartburn medications immediately after surgery. There is no need to taper down PPI dose after Nissen fundoplication. Some are concerned about rebound gastric acid secretion after stopping PPIs. Nissen fundoplication is so effective at stopping acid reflux even in the case of transient increase in gastric acid secretion.