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.