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Laporascopic Nissen Fundoplication

Dear Doctor,

I am a 30 year old British Male who has suffered from acid reflux for around a decade.  In the past I have been quite overweight, although I am now in proportion at 5'11" and 168lbs.  Otherwise excellent health.

I currently take 20mg of Omperazole once per day (and have done for 18months), which has completely eliminated all traces of heartburn and discomfort., although I do still notice that I burp more than most people.

In July 2009 (after six months of PPI therapy) I was advised to discontinue for a couple of weeks and then undergo an Endoscopy, which I did.  Heartburn symptoms did return during my time off the PPIs, as expected.

The endoscopy was performed by a well respected consulting gastro who reported the following:-

5cm Hiatal Hernia
Grade 2 Esophagitis described as very superficial
Clearly defined Z line
Negative for Barretts
Negative for H Pylori

Once back on PPIs all heartburn eliminated.  

I am now considering Lap. Nissen Fundoplication to treat my GERD but given that I am asymptomatic on low doses of PPI, I'm not sure if this is for the best in the long term or not.  My main reason for considering this surgery is the possible reduced long term risk of developing Barretts or worse compared with PPI therapy.

In your expert opinion, would a person in my position be better off with immediate surgery or continued PPI therapy perhaps with surgery at a later date.  As discussed, my main driver is the reduction of the risk of BE and it's associated complications.  (I have read that if BE is not present on initial endoscopy after years of GERD it is unlikely to develop in the future, however given my relative young age I'm not sure if this would still hold).

Thanks again and king regards,


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Avatar universal
If symptoms are controlled with PPI then it is  less likely you may develop Barrett's esophagus if you continue taking PPI.
PPI are safe medications and can be taken without serious side effects.
Surgery is indicated when there is no relief with PPI or  you do not want to take PPI for a long term.
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