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January 13, 2005
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When medication and lifestyle changes aren't enough
When treating heartburn, the first course of action is to try prevention through lifestyle changes, such as what to eat or not eat, sleeping position, etc. If lifestyle changes alone aren't sufficient to handle the chronic acid reflux, medications are often used. But what happens when none of these methods work?

When lifestyle changes and medications no longer ease the chronic acid reflux, doctors may opt for various procedures to handle the problem.

Non-Surgical Procedures
Some endoscopic procedures are nonsurgical and are less invasive than surgery. Doctors will usually consider less invasive measures first. These procedures include the Enteryx procedure, which is a polymer device and a solvent that is implanted in the wall of the cardia during an endoscopy, and the Stretta procedure, which uses radiofrequency energy delivered to the lower esophageal sphincter and gastric cardia (uppermost part of the stomach), improving the function of the LES.

Surgical Options
With long-term GERD, complications may occur, and surgery may be the only option. One of the more commone procedure is the Nissen Fundoplication, which is a type of laparoscopic surgery for treatment of GERD.
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