Advice after GERD for 3 years

[moh_fahmy]

DEAR DOCTOR

Life has not been that pleasant for the past years. I have been experiencing GERD for the past 3 years. Heart Burning experienced after waking up, going to the GYM, tension at work, plus spicy food, tomato sauces, and fatty food. I have have done all the life style changes required ... but nothing worked.
I have been on medication Nexium 40mg, the Nexium 20 mg, then other PPIs together with Anti Acids.
No matter what I do I try any of the above activity I have a good chance of getting reflux at least twice per week.
I have done an endoscopy from 6 months ago, Dr. said stomach and esophagus lining is normal yet confirmed that I have GERD, and this has been identified by the Barium that has been done to me.
I am in a another country now, and visiting another Doctor. He said he will need to do the endoscopy again, and PH monitoring ... I will under go both in the coming 2 weeks. I am 99% sure he will come back with confirmation that I have GERD, and I believe no matter what the medications he gives me, it wont fix the heart burns.
If the next step will be the operation, I am working in the Middle East now.
1) Where would you suggest the best medical center in Europe or anywhere else specilized in such operations?
2) There is a new advertised less invasive operation called esophyx How http://www.stopreflux.com/. What is your advice here?
3) There is allot of info out there pro and against GERD operations. Some say 90% success rate, others say that is only for a couple of years, some reports say that after a couple of years a considerable amount get GERD back. What you take on this?

Your honest advice is kindly appreciated

Regards,
MMF

[LLWB]

I had the nissan fundiplication over 8 years ago, and have not had an recurrent problems. Not 1. I highly recommend it. I have no experience with any overseas medical centers. Please look into it, you will be glad you did.

[Ratnakar Kini]

Hi MMF,
The confirmatory test for GERD is 24 hours pH monitoring.

And PPI is the best medication for Acid reflux.

If you are not responding, the test has to be repeated.

Some patients suffer from bile reflux for which the treatment is different.

Regarding the surgery, it is the last resort for GERD. The success rate is said to be around 90%. Esophyx is a less invasive surgery.
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The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.
- Ratnakar Kini M.D.