About 20% of people in the United States have GERD, which means struggling with a burning sensation after dinner or a sour taste when you lie down, when food or liquid seems to come back up into your throat. For some, over-the-counter medications work, but many GERD sufferers need more than that. Modern GERD treatment relies on determining whether reflux is actually causing your symptoms, identifying what is happening at the junction between the esophagus and stomach, and understanding how well your esophagus moves food. 

If you’ve taken GERD medication for years and still have symptoms, read on to learn how the best GERD doctor in Los Angeles can determine whether surgery is the answer. 

How Do GI Doctors Know When GERD Requires More Than Medication?

Anti-reflux surgery is generally considered when GERD is confirmed and symptoms remain troublesome despite appropriate medical treatment, when medication is not tolerated, or when a patient prefers a procedural approach after discussing the risks and benefits. 

Does GERD Always Require Surgery for Permanent Relief?

Needing medication does not automatically mean you need surgery. In fact, proton pump inhibitors, commonly called PPIs, are effective treatments for many people with GERD. However, when patients come to our office saying, "My heartburn is not getting better with medication," surgery may become an option. 

Persistent symptoms can have several explanations: 

  • The PPI treatment may not be adequately controlling reflux
  • The symptoms may be caused by non-acid reflux
  • There may be an esophageal motility disorder
  • Or the symptoms may not be related to reflux at all

What Tests Help Determine Which GERD Procedure Is Right for You?

A thorough GERD evaluation will include upper endoscopy, reflux monitoring, and esophageal manometry. Each test answers a different question, and that information can directly affect treatment decisions: 

Upper Endoscopy

An upper endoscopy, or EGD, allows a physician to examine the esophagus, stomach, and upper small intestine. It can identify inflammation, narrowing, ulcers and Barrett's esophagus, among other conditions. It can also provide important information about the anatomy around the gastroesophageal junction and help identify a hiatal hernia.

Acid Reflux Monitoring

A Bravo wireless pH test or catheter-based pH-impedance study can measure reflux over time. This is particularly useful when the diagnosis is uncertain or when a patient is being considered for anti-reflux surgery. The test can determine how much reflux is occurring and, with impedance testing, can detect reflux that is not strongly acidic.

Esophageal Manometry

Manometry measures how the muscles of the esophagus contract as you swallow. Before anti-reflux surgery, this test can help identify disorders that could change the treatment plan. It also helps determine whether the esophagus is generating adequate pressure to move food through the newly reconstructed gastroesophageal junction.

Which Anti-Reflux Procedure Is Best?

There is no single anti-reflux operation that is ideal for every patient. The choice depends on anatomy, reflux severity, esophageal function, other health considerations, and the patient's priorities.

Procedure How It Works When It May Be Considered
Stretta Uses radiofrequency energy delivered through an endoscopic catheter to treat the muscle at the lower esophageal sphincter and reduce reflux symptoms Selected patients with GERD who may benefit from an endoscopic approach and do not have an anatomy that requires surgical repair
Hiatal Hernia Repair / Paraesophageal Hernia Repair Repairs and reinforces the opening in the diaphragm where the esophagus passes into the abdomen, restoring the normal anatomy and reducing reflux or hernia-related symptoms Patients with a symptomatic hiatal or paraesophageal hernia, particularly when the hernia contributes to GERD or creates a risk of complications
Fundoplication Wraps part or all of the upper stomach around the lower esophagus to strengthen the anti-reflux barrier and prevent stomach contents from flowing backward Patients with objectively confirmed GERD, particularly those with significant reflux, regurgitation, or a hiatal hernia who are appropriate surgical candidates
LINX Places a small ring of magnetic beads around the lower esophageal sphincter to strengthen the anti-reflux barrier while allowing the sphincter to open during swallowing Selected patients with confirmed GERD who have appropriate anatomy and are candidates for magnetic sphincter augmentation
Collis Gastroplasty Surgically lengthens a shortened esophagus by creating a tubular extension from the upper stomach, allowing the gastroesophageal junction to sit properly within the abdomen Patients with a shortened esophagus, often associated with a large or complex hiatal or paraesophageal hernia, when adequate esophageal length cannot otherwise be achieved
TIF (Transoral Incisionless Fundoplication) Uses an endoscopic device passed through the mouth to reconstruct the anti-reflux valve at the gastroesophageal junction without external incisions Carefully selected patients with confirmed GERD who have appropriate anatomy and may benefit from an incisionless endoscopic approach

What Is Recovery Like After Anti-Reflux Surgery?

Recovery depends on the procedure performed, your overall health, and whether additional work, such as hiatal hernia repair, is required. The best GERD doctor in Los Angeles performs anti-reflux surgery using minimally invasive techniques for a faster recovery. Despite this, some patients may experience temporary swallowing difficulty, changes in eating patterns, bloating, or increased gas. 

After surgery, you will often be instructed to follow a specific diet during the early healing period. Activity restrictions also vary, particularly when a hiatal hernia has been repaired. The best GERD surgeon in Los Angeles will provide specific instructions regarding lifting, exercise, driving, and returning to work.

Where to Find the Best GERD Treatment Doctor in Los Angeles

The modern approach to GERD surgery relies on finding the procedure that makes sense for a specific patient. Symptoms, reflux testing, esophageal motility, hiatal hernia anatomy, body weight, previous procedures, and personal priorities can all influence that decision.

Our approach to modern GERD treatment begins with evaluating the larger picture. Dr. Danny Shouhed is a board-certified minimally invasive surgeon with fellowship training in bariatric, foregut, and complex general surgery at Mount Sinai Hospital. He completed his surgical residency at Cedars-Sinai, where he served as administrative chief resident, and later returned to Cedars-Sinai as a leader in minimally invasive and robotic surgery.

Dr. Shouhed has also published more than 40 peer-reviewed articles and book chapters and has developed extensive experience in robotic, gastrointestinal, and foregut surgery. His training across minimally invasive, bariatric, and complex gastrointestinal surgery allows us to consider GERD within the context of the patient's entire anatomy and health rather than treating reflux as an isolated symptom.

Ready to get lasting relief from the best GERD treatment doctor in Beverly Hills?