Discussion Points for You and Your Physician


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Discussion Points

First you need to take an honest look at your life style and take ownership of this problem.  The first line treatment of GERD is lifestyle modification.  Bolster your nutrition, exercise sensibly, and stop smoking. You likely need to lose weight as fat deposits in your abdomen push the GEJ into the chest and make GERD worse. Nicotine, caffeine, and alcohol all contribute to a loose lower esophageal sphincter (LES) which makes GERD worse.  Additional maneuvers such as eating more than 3 hours prior to sleeping or elevating the head of your bed may also help symptoms.  Get the help of others in these areas because this is not an easy area to change our habits. On the bright side, if you can accomplish the above you may not need medications or surgery. As most things in life it’s up to you.

If you have tried all of this, including medications, and still have severe symptoms, then you may benefit from surgery, especially if you have an advanced mechanical problem with your GEJ. As a surgeon I realize not every intervention is right for everyone. You need to tailor the treatment to what the patient needs. When meeting with your surgeon important talking points are:

  • What procedure would they recommend and why?
  • What are the particular anatomic or physiologic factors present in your case to support this approach?
  • What are the benefits, risks, and alternatives to the proposed treatment?
  • What can I do as a patient to prepare myself to get the best result?


A physician should also have a long term plan to manage your care and follow your results and satisfaction. Patients in our practice receive a GERD Quality of Life (QOL) score, barium esophagram, and other imaging as needed for 3-5 years after their surgery to maintain and track optimal results.

As surgeons who does primary anti-reflux surgery (laparoscopic, open, and endoscopic) and also takes on failed cases from outside institutions, we understand how important long term follow-up is.