How to know if you should have Fundoplication

Hi!  I was diagnosed with Barrett's Esophagus, esophagitis, minor hiatal hernia and esophageal spasms back in April of 2010.  I am currently taking Capidex in the morning and Zantac (prescription) at night.  My doctor recently told me to start taking Gaviscon in between these times when I have flare ups of acid reflux, which happens still about 2 to 3 times a week.  Last month, my gastrologist said that I also have esophageal spasms that are the reason why I'm feeling some difficulty breathing sometimes when I feel the acid in my throat.  I vomit burp several times a week and swallow it back down.  Nasty, I know.  I'm 39 years old.  My next appt. with him is in November.  He wants to see how the medicine for the esophageal spasms works.  I understand that doctors have to try to use meds first before going to surgery for various reasons.  No one wants surgery and then also, the insurance companies don't want to be paying out for surgeries without having enough of a reason for one.  My question is whether I should really push my doctor on my next visit to try to get the fundo?  Does it sound like something that I would be a good candidate about?  I don't know if I should get a second opinion if he says no.  I'm just trying to be informed, especially with all of the money that I've had to pay out this year.  Yes, I already had the barium swallow and the endoscopy, which is how he came up with the diagnoses above except he just recently came up with the esophageal spasms.  Thanks for any opinions and directions that you might have.

Chris

[Ratnakar Kini, MD]

Hi,
Surgery is indicated -
1. If you don't find any relief with medications
2. You get relief, but don't want to continue taking medications on a long term and on stopping medications the symptoms return.