Reflux & Fundoplication Surgery

What is reflux?

Reflux is a fairly common condition, often known as heartburn, as it creates a burning sensation/pain in the lower chest area. This happens when stomach acid escapes the stomach and flows into the oesophagus (food pipe).

The entrance to your stomach is controlled by a valve, which is a ring of muscle (the lower oesophageal sphincter or LES). When food passes through the LES to the stomach, this ring of muscle closes immediately afterwards. If the LES doesn’t completely close or if it opens too often then acid produced by your stomach escapes and moves up into the oesophagus. This is called reflux or heartburn.

Reflux is quite common, but if you experience acid reflux symptoms more than twice a week or on an on-going regular basis you may have acid reflux disease, known as Gastro-Oesophageal Reflux Disease (GORD).

Gastro-Oesophageal Reflux Disease (GORD)

During normal digestion, the LES opens to allow food to pass to your stomach. In patients suffering with GORD, the LES is weak or relaxes when it shouldn’t, resulting in pain from acid flowing up into the oesophagus.

Reflux - symptoms

Reflux is quite common; many people experience reflux at different times in their lives (such as during pregnancy) or after eating (for example spicy or greasy foods). The symptoms of reflux are quite well known:

  • Burning sensation – this is known as ‘heartburn’. It is a burning pain or discomfort that can be present from the stomach, to the abdomen or chest, even into the throat.
  • Regurgitation – a bitter or sour tasting acid rising in your throat or mouth.

Other less common symptoms of acid reflux can include:

  • Dysphagia – the sensation of food being stuck in the throat.
  • Burping
  • Hiccups (that continue for a long period of time).
  • Nausea
  • Chronic sore throat or hoarseness.

If you are experiencing any of these symptoms on a regular basis (two or more times a week) or if reflux medications don’t bring lasting relief, you should speak to your doctor.

Reflux - diagnosis

If your doctor suspects you may be suffering with reflux or GORD following a physical exam and a series of tests, you will likely be referred to a specialist who will perform the some or all of the following diagnostic tests:

  • Barium Swallow
  • Oesophageal Manometry
  • 24hr pH Monitoring
  • Endoscopy
  • Biopsy

Reflux Treatment & Surgery

Reflux can often be effectively treated with diet and lifestyle changes. For example if certain foods or drinks trigger symptoms, then try to eliminate these from your diet (or consume in smaller amounts, less frequently). Other steps you can take include eating smaller meals, not eating before lying down/going to bed, or taking steps to lose weight if you are overweight or obese.

Your doctor may suggest combining diet and lifestyle changes with over-the-counter medications as part of your reflux treatment. For example, antacids can neutralise the acid from your stomach, which can ease the pain caused by reflux. If antacids don’t help, your doctor may try other medications such as foaming agents (like Gaviscon), H2 blockers, proton pump inhibitors or prokinetics.

If lifestyle changes and medications aren’t providing sufficient relief of pain caused by reflux/GORD, your doctor may recommend reflux surgery. Reflux surgery is a ‘last resort’ option for treating acid reflux disease, after all other treatments have been tried first. The surgery recommended to treat chronic acid reflux or GORD is called fundoplication.


Fundoplication is the standard surgical procedure for GORD. Fundoplication is usually performed via minimally invasive surgery (robotically or laparoscopically). A/Prof Pilgrim will make small incisions in your abdomen and feed the camera and instruments into place, which allows him to perform the surgery.

During fundoplication surgery, A/Prof Pilgrim will take the upper part of the stomach (the fundus) and ‘wrap’ and stitch this around the LES. By doing this, it improves the pressure in the oesphagus by tightening the muscle, lessening the chance of acid from the stomach escaping and reducing the instances of acid reflux.

If you are currently suffering from acid reflux or GORD and would like to discuss diagnosis, treatment or surgery options, please call us on (03) 9509 4811 to make an appointment, or you can book an appointment online