Free download, 6 pages
If you have been on a reflux pill for years, this explains why
A proton pump inhibitor reduces the acid your stomach makes. It does not move a hernia or tighten a failed valve. This guide walks through the difference, the four tests that actually decide your treatment, and how the operations compare when someone states the trade-offs instead of selling one.
01
Acid versus anatomy
Why omeprazole can control your acid and still leave you refluxing, and how to tell whether your problem is acid production or a mechanical barrier that has failed.
02
Four tests, four different answers
Endoscopy, pH study off medication, manometry and esophagram. What each one actually tells us, and why choosing an operation without manometry is how a technically perfect repair produces a miserable patient.
03
The operations, side by side
Hiatal hernia repair, Nissen and Toupet fundoplication, TIF and magnetic sphincter augmentation in one table, each with its honest trade-off rather than its brochure.
04
Barrett's esophagus, in proportion
What the risk actually is, why it is diagnosed by biopsy rather than appearance, and what surveillance looks like. Neither dismissed nor turned into a scare.
05
Reflux after a gastric sleeve
The complication most sleeve patients are never warned about, why a fundoplication is impossible afterward, and the screening endoscopy that guidelines recommend at three years and almost nobody gets.
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Medically reviewed by Dr. Roger Eduardo, MD, FASMBS, Board-Certified General Surgeon. Last reviewed August 2026.
Book a consultation →Who it is written for
Download it if any of this is you
- ◆You have taken omeprazole or pantoprazole for years and still have symptoms.
- ◆You have been told you have a hiatal hernia and left it there.
- ◆Your reflux is worse since a gastric sleeve, or it never improved the way you were told it would.
- ◆You have a Barrett's esophagus diagnosis and are not sure what happens next.
- ◆You have a chronic cough, hoarseness or a lump-in-the-throat feeling that nobody has connected to reflux.
- ◆You want off the daily pill rather than on a higher dose of it.
Why this guide exists
Most reflux content is written to sell one procedure
Practices that only perform an endoscopic procedure explain why you do not need surgery. Practices that only perform a wrap explain why the endoscopic option does not last. Dr. Eduardo is fellowship-trained in foregut surgery and performs all of it, including the revisional bariatric work, so the guide can afford to state the case against each option.
Every figure in it is cited to a published study or a society guideline, listed on the final page. Individual results vary.
After you read it
Three ways to keep going
Start with facts
Understand the testing
Endoscopy, pH study and manometry, and what each one rules in or out.
Two minutes
See if you are a candidate
A short screening quiz. Nothing you enter is stored anywhere.
When you are ready
Book a consultation
Bring your prior operative report if you have one, and we start from what was actually done.
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