Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Consider referring a patient with GERD for surgical evaluation, such as fundoplication, if they have a confirmed diagnosis of acid reflux and are either:
- Symptomatic despite adequate symptom control with acid suppression therapy, and do not wish to continue long-term therapy NICE CG184.
- Responding to a PPI but cannot tolerate acid suppression therapy NICE CG184.
- Have persistent, refractory, or unexplained symptoms despite treatment NICE CKS.
- Have suspected GORD and are considering surgery, especially if they have risk factors for Barrett's oesophagus, which warrants specialist assessment NICE CKS.
Key References
- CKS - Dyspepsia - proven GORD
- CG184 - Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management
- NG1 - Gastro-oesophageal reflux disease in children and young people: diagnosis and management
- CKS - GORD in children
- NG231 - Barrett's oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management