Acid Reflux Treatment

Acid Reflux Treatment

Treatment for GERD; Repair of Hiatal Hernia, Paraesophageal Hernia

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When diet and medication no longer control chronic heartburn -- also known as acid reflux or gastroesophageal reflux disease (GERD) -- minimally invasive acid reflux procedures may be your best option. Duke surgeons in Durham and Raleigh repair the underlying causes of GERD, as well as hiatal hernias including paraesophageal hernias. We offer an endoscopic procedure through the mouth that may help you find lasting relief.

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When to Seek Treatment for Acid Reflux

Understanding GERD
GERD occurs when the acidic contents of the stomach back up into the esophagus, causing symptoms such as burning behind your breastbone, belching, an acid taste in your mouth, or swallowing difficulties. Occasional heartburn can be treated with diet and lifestyle changes, over-the-counter antacids or prescription medications, including proton pump inhibitors. However, these options can’t fix the underlying problem when a hiatal hernia is present, or if the cause is a weak, ineffective muscle at the bottom of your esophagus.

Complications of Untreated GERD
If left untreated, chronic reflux can cause painful irritation called esophagitis. It can also cause precancerous changes in the lining of the esophagus, called Barrett’s esophagus, which is believed to be a precursor to the development of esophageal cancer. In rare cases, severe reflux can cause hoarseness, permanent vocal changes, and even severe narrowing of the esophagus, called strictures.

Acid Reflux Procedures Repair Hiatal Hernias
Our surgeons also repair hiatal hernias (including a type of hiatal hernia called paraesophageal hernia), which occur when the stomach and other abdominal organs enter the chest area through the hiatus, a naturally occurring hole in the diaphragm. The presence of a hiatal or paraesophageal hernia allows acid to flow freely into the esophagus and may cause additional symptoms including nausea, vomiting, chest pain, heartburn, and difficulty swallowing.

Our Locations
Duke Health offers locations throughout the Triangle. Find one near your acid reflux.


The following tests help us decide on the best treatment option for you.

Barium Swallow

Also called an esophagram, this X-ray of your esophagus allows your doctor to evaluate your degree of reflux and look for a hiatal hernia. 

Upper Gastrointestinal Endoscopy

Your doctor inserts a flexible tube into your mouth to view the inside of your esophagus, stomach, and small intestine.

Esophageal Manometry

A tiny electronic device is inserted through your nose via a thin, flexible tube called a catheter. It detects weaknesses within the esophagus by monitoring strength and patterns of muscle function.

Esophageal Acidity Test

Measures acid content within the esophagus to diagnose reflux and its severity.

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Acid Reflux Treatments

As a comprehensive center for the surgical management of reflux, we offer several approaches to treat GERD, hiatal hernias, and paraesophageal hernias. 

Surgical Fundoplication

Duke surgeons use small incisions to reach the esophagus. They wrap part or all of the stomach around the lower esophagus to strengthen the muscle and stop acid reflux. This is the standard surgical treatment of GERD.

LINX Magnetic Band

Using this minimally invasive approach to reach the esophagus, your surgeon wraps a ring of magnetic titanium beads around the lower esophageal muscle to prevent the contents of your stomach from backing up into your esophagus. It does not prevent food or liquids from traveling down the esophagus into your stomach. 

TIF (Transoral Incisionless Fundoplication)

Small instruments are passed through an endoscope, which is inserted in your mouth to reach your stomach. No incisions are required. The surgeon wraps the upper part of your stomach around your lower esophagus and uses a special device to recreate the esophageal valve that prevents stomach acid from regurgitating into your esophagus.

Gastric Bypass Surgery

If you experience GERD caused by obesity, gastric bypass surgery can bring relief by removing the acid-producing portion of the stomach. 

Why Choose Duke

Advanced training, experience, and a large number of procedures performed count when choosing a surgeon to treat your acid reflux.

Extensive Experience
Our esophageal surgeons are board certified in general surgery and have completed additional fellowship training in thoracic surgery of the chest. This includes specialized procedures in and around the esophagus.

More Complex Procedures
Robotic surgery allows our surgeons to visualize the surgical site better. The dexterity of the robotic hands allows doctors to do more complex procedures in smaller areas and place sutures more precisely.

Leaders in Innovative Techniques
We were the first center in North Carolina to implant the LINX device and use the TIF device for GERD. We are constantly looking for newer, less invasive options to give people freedom from chronic reflux.

High Volume Referral Center
People are often referred to our surgeons for management of GERD and its symptoms. Patients frequently travel to us from nearby regions.

Among the Best Hospitals for GI in the U.S.
Where you receive your care matters. Duke University Hospital is ranked among the best in the nation for gastroenterology and GI surgery by U.S. News & World Report for 2019–2020.
Reviewed: 05/23/2018