Acid Reflux

Question: My child has been treated for acid reflux with medications since birth. We have been managing her reflux ok until about two years ago, when she started to have recurring pneumonia, which the doctors treating her believe is due to aspiration while reflux. Is it time to consider a surgical solution? If yes, which one is the most recommended? Thank you for your help.

Answer: Nissen or Toupet fundoplication are two popular reflux surgeries. Toupet is associated with less post-op gas/bloat or dysphasia. They would need to talk with a surgeon to discuss the risks and benefits of the surgical option.

If the patient is able to cooperate, an esophageal manometry and 24-hour pH study (they are awake for this) help guide which surgical option is best. If the patient cannot cooperate with that, I would recommend pre-op EGD with pH BRAVo study.

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