Surgery is considered for those who remain symptomatic even with medications and life-style changes, or patients who cannot tolerate the medications. The principles behind surgery for GERD are :

• to maintain an intra-abdominal position for the lower oesophagus.
• to recreate a sphincter-like wrap at the upper part of stomach to function like a valve (fundoplication).

The operation may be performed either in open procedure or laparoscopically.

The investigations and treatment of various causes for GERD require time with the doctor for detailed and continued clinical evaluation. Findings on various procedures or imaging require careful correlation with symptoms and well-being. Often the benign causes are effectively treated with standard and uncomplicated treatments.