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5% to 8% of patients who have chronic reflux may develop a Barrett’s esophagus which results in a change in the normal esophageal mucosa to a type of lining that is more of an intestinal type. A gastroscopy with esophageal biopsies is the only definitive way to make this diagnosis of a Barrett’s esophagus.. There are no specific symptoms for Barrett’s esophagus and the risk of a cancer developing in the setting of a Barrett’s esophagus is very low. |
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The bacterium is called Helicobacter pylori (H. pylori). This is a common bacterium that infects the stomach and may cause about 10% of people with the bacterium to develop an ulcer. As a rule, one does not look for H. pylori in the setting of reflux. |
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There have been some endoscopic techniques that have been developed that can increase the lower esophageal sphincter pressure but presently they are more experimental and do not have a role in the treatment of reflux. |
Complications can occur from surgery with 5-10% of patients. These include making the wrap too tight and developing problems swallowing one’s food, accidental injury to the spleen requiring removal of the spleen, post-operative hernia formation developing diarrhea, inability to burp and loosening of the wrap over time with recurrent reflux needing medication.
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There are some special circumstances where surgery may be of value for those having troublesome retrosternal burning and extraesophageal symptoms of cough, asthma, voice change and pulmonary infections inspite of a trial with at least a double dose of a proton pump inhibitor. It is important to confirm that there is increased acid present in the esophagus with a 24 hour pH test. Some people who regurgitate fluid that is very troublesome may benefit from surgery. There are some people who respond to the drugs but have side effects from the drugs, find them too expensive or simply don’t like taking medications. This group would benefit from surgery.
People who continue to have symptoms even with a twice a day dose of a proton pump inhibitor and the 24 hour ph test is normal should look to be tested for other problems as this is not in keeping with acid reflux. |
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Important: This information should not be used as a substitute for the medical care and advice of your physician. 
