GERD Surgery Treatment Options When You Suffer from Acid Reflux

Written by Dr. James Buwen, FACOS | Medically Reviewed by Dr. Michael Fastiggi, FACS on August 7, 2025

Still Suffering from Acid Reflux while on Medication for GERD Treatment? GERD Surgery May Be An Option for a More Permanent Acid Reflux Solution.

Tomato sauce, coffee and onions. If you’re wondering what these foods have in common, you probably don’t regularly suffer from heartburn or acid reflux or GERD. If you do have acid reflux, you instantly recognized these foods as ones that you probably can’t eat without unpleasant consequences.

Medications can help, but when should you start to think about a more permanent solution than a lifetime of medication? The good news is that these days there are safe and effective surgical options for acid reflux – even if you’ve had bariatric surgery and have been told there are few options.

Understanding Acid Reflux or GERD

Let’s take a look at why acid reflux occurs in the first place. Acid Reflux, or gastroesophageal reflux disease (GERD), occurs when acids “back up” from the stomach into the esophagus, causing a burning sensation in your chest. Being overweight puts you at a higher risk of GERD. Losing weight, along with other lifestyle changes such as quitting smoking, can help with symptoms.

Many bariatric surgery patients find their reflux symptoms get much better after weight loss. However, in some cases, particularly for gastric sleeve patients, GERD can worsen. And there is research that shows that GERD can develop in a very small percentage of patients who did not have it prior to gastric sleeve surgery. Over-the-counter antacids or prescription medications help reduce the amount of acid in your stomach, but medications do not cure acid reflux.

Since GERD is not caused by an overproduction of acid but by a weak muscle at the bottom of the esophagus, called the lower esophageal sphincter (LES), medication can not cure Acid Reflux.

The LES acts like a one-way valve, allowing food to pass into the stomach. Normally, the LES closes immediately after swallowing to prevent your stomach juices from backing up into the esophagus. When the LES is weak, acid flows back into the lower esophagus, causing irritation and inflammation that may eventually damage the esophagus.

Heartburn is one symptom of acid reflux disease that most people have at some point in their lifetime. Frequent GERD can lead to potentially serious complications, such as esophagitis (damage to the lining of the esophagus), a narrowing of the esophagus known as stricture, or even cancer.

Some people are born with a naturally weak sphincter. For others, it may relax and weaken over time. Additionally, a hiatal hernia or weakness in the muscles surrounding the lower esophagus, contributes to the development of acid reflux.

When to Consider GERD Surgery for Acid Reflux

Patients at our practice who are interested in a surgical solution to Acid Reflux or GERD typically have the same thing in common: They are tired of taking medications that don’t completely control their symptoms. If this sounds like you, you may want to consider minimally invasive GERD surgery for the treatment of Acid Reflux.

Types of GERD Surgery

LINX Reflux Management System – Approved by the FDA in 2012, LINX is the latest surgical option for patients suffering from GERD and has many benefits over traditional anti-reflux surgery. LINX is a flexible ring of small magnets (about the size of a quarter) that is placed around the LES during a minimally invasive laparoscopic procedure. The magnets help the weak LES to open when it should (while swallowing food) and close when it should, preventing acid reflux.

In a 2016 study, up to 85% of patients were free from dependence on daily reflux medication after treatment with LINX. In addition, LINX requires no permanent changes to the anatomy. This is especially important for post-op gastric sleeve patients whose only prior surgical option was to convert to a gastric bypass. This is a conversation you should have with your bariatric surgeon to determine the right course of action.

Laparoscopic Nissen Fundoplication – The traditional GERD surgery for acid reflux, Nissen Fundoplication is a minimally invasive laparoscopic procedure that involves repairing your hiatal hernia, if present, and wrapping the top part of the stomach around the end of the esophagus (like a hot dog in a bun) to reinforce the LES. Due to the nature of the surgery, this is a not an option for post-op sleeve patients. Your bariatric doctor will help you determine if you are a candidate.

Conversion to Gastric Bypass from Sleeve Gastrectomy – For gastric sleeve patients only, a conversion to a gastric bypass may be beneficial if you suffer from GERD and are not satisfied with your weight loss from your initial surgery. Again, speak to your bariatric surgeon, who will determine if you are a candidate.

Minimally invasive anti-reflux procedures have short recovery times, allowing patients to return to work quickly. As with any surgery, acid reflux procedures are associated with potential surgical risks that your surgeon will review with you. If you think you may be a candidate for any of these procedures, have a conversation with your bariatric surgeon who will help you determine the best options for your specific situation.