If you suffer from persistent heartburn, regurgitation, or chest discomfort, you may be among the millions of Americans living with gastroesophageal reflux disease (GERD).
While medications and lifestyle changes help many, some individuals require more advanced GERD treatments to achieve lasting relief. At Hoag, we offer a range of surgical and endoscopic options tailored to your unique needs, so you can feel better for good.
When Is Surgery or an Endoscopic Procedure the Right Choice?
GERD occurs when there is a breakdown in the natural barrier that prevents stomach acid from flowing back into the esophagus. This barrier is made up of multiple structures, including the lower esophageal sphincter (LES) – a circular muscle at the bottom of the esophagus, the natural valve from normal anatomy of the stomach, and the stomach being below the diaphragm in its normal anatomic position. For patients whose GERD symptoms remain unresolved despite diet changes or medications, surgical or endoscopic interventions may offer the most effective path forward.
“The key to treating GERD effectively is understanding the root cause,” says Dr. Katie Blevins, Bariatric and Foregut Surgeon at Hoag’s Digestive Health Institute. “At Hoag, we use advanced diagnostics to guide treatment, ensuring each patient receives the option that fits their condition and lifestyle. We have expertise in all treatment options available and will help guide our patients to their best fit.”
Surgical Treatments for Long-Term Relief
Hoag’s Digestive Health Institute is at the forefront of GERD care, offering advanced options including:
- Hiatal Hernia Repair
Commonly, a hiatal hernia is the underlying cause of GERD. A hiatal hernia is when the stomach slips above the diaphragm into the chest due to weakening or widening of the muscle, leading to a breakdown in the natural barrier that prevents reflux. Surgical repair of these hernias fixes anatomical issues by restoring the stomach to its proper position and strengthening the diaphragm.
- Surgical Fundoplication
Surgical anti-reflux procedures are often various types of fundoplication. This includes a complete 360-degree wrap (Nissen) or partial wraps including Toupet, Dor, or Watson. These operations are performed using minimally invasive laparoscopic or robotic technology, allowing for shorter recovery and fewer complications. Choosing which fundoplication is performed depends on each patient’s specific anatomy, symptoms, and presurgical testing.
- c-TIF
This is a newer hybrid technique that combines surgical hiatal hernia repair with a Transoral Incisionless Fundoplication (TIF) procedure. These are done in the same procedure, usually in collaboration with a surgeon and advanced gastroenterologist.
- LINX® Reflux Management System
An FDA-approved implant placed around the LES to prevent reflux while preserving natural function.
“Hoag is proud to be one of a few centers in California offering LINX,” says Dr. Adrian Dobrowolsky, Medical Director of the Bariatric Weight Loss Program and Foregut Surgeon at Hoag’s Digestive Health Institute. “It’s a game-changer for many patients seeking long-term relief from GERD symptoms without altering the stomach, like with a fundoplication, leading to faster recovery.”
- Expert Surgical Solutions
From hiatal hernia repairs, and partial to complete fundoplication, our surgical team tailors each procedure for optimal outcomes.
- Leading-Edge Endoscopy
With techniques like TIF and Stretta, our GI experts deliver non-surgical solutions for lasting symptom control.
Minimally Invasive Endoscopic GERD Treatments
If you’re looking for less invasive GERD treatments, endoscopic options can be highly effective:
- Transoral Incisionless Fundoplication (TIF)
TIF repairs the LES using an endoscope inserted through the mouth, with no external incisions. It’s minimally invasive and offers a quicker return to daily activities.
- Stretta Therapy
An outpatient procedure that delivers radiofrequency energy to the LES, strengthening the muscles and reducing reflux episodes.
- Endoscopic Suturing (Plication)
This technique uses endoscopic tools to place sutures around the LES, tightening it and providing relief for patients who are either not yet ready for surgery or who are not candidates for surgery.
Choosing the Right GERD Treatment
Selecting the right treatment depends on a thorough evaluation of your GERD symptoms, medical history, and lifestyle. At Hoag, we believe in a personalized approach.
“Every patient’s experience with GERD is different,” explains Dr. Kenneth Chang, Executive Medical Director of the Hoag Digestive Health Institute. A world-renowned researcher, inventor, advanced endoscopist, and pioneer in interventional endoscopy and endoscopic oncology, Dr. Chang emphasizes the importance of personalized care.
“Our job is to help patients understand their options and choose the best course of care for their needs.” He highlights Hoag’s exceptional team and advanced surgical and endoscopic capabilities, which allow for tailored treatment—from medical management to minimally invasive procedures and cutting-edge endoscopic interventions.
Take the Next Step Toward Lasting Relief
Thanks to major advancements in diagnostics and GERD treatments, long-term relief is more achievable than ever. Whether you’re managing mild symptoms or seeking alternatives to medication, Hoag’s Digestive Health Institute is here to support you with expert care close to home.
Explore your options with Hoag and find a personalized path to relief from GERD symptoms.
