LPR Surgery – What Are Your Options?

lpr surgery

When it comes to LPR (Laryngopharyngeal reflux) and surgery you have a selection of different options available to you. The best options for LPR surgery are Nissen Fundoplication, Stretta Procedure and Linx. All of which have shown to be quite effective at helping LPR particularly the Fundoplication and Stretta.

If you are suffering from Laryngopharyngeal reflux LPR (silent reflux) one of the options that maybe you want to consider is surgery to fix your problem. Of course, if you haven’t tried the likes of an LPR diet or things like Gaviscon advance I would first recommend you try them out first before considering surgery. Also, I would recommend you check out my complete LPR guide as well.

Surgery is something for someone who has tried everything available to them to no avail. After that you will likely need some tests to figure out what surgery may be effective for you. For example, the most accurate test to check for LPR is the Restech pH test. If you definitely have LPR then you will need more tests to determine what is causing your LPR in the first place.

For example, gastric emptying study, pH monitoring (Restech), esophageal motility and even an electrogastrogram. I cover some of the diagnosis options in more detail on this article – Acid Reflux / GERD – Ultimate Guide.

After you have been properly diagnosed you then can consider LPR surgery options. Below I will cover each of the surgeries that are designed to treat acid reflux, so then you know your options that you have available to you. Of course, depending on your situation one option may be the better choice than another.

Laryngopharyngeal Reflux / Silent Reflux Surgery Options

Stretta Procedure

Stretta isn’t like most other procedures as it is minimally invasive and doesn’t require any incisions, stiches or implants. This clearly makes it a preferable option because you can return to normal activities the following day whereas with the other options there will be more time needed for healing before returning to normal activities.

As I am sure you are asking yourself “how does Stretta work” – well it uses a radiofrequency energy which to sent to the muscle between the stomach and the esophagus. This radiofrequency energy will help remodel and improve the muscle tissue in this area. This process will help make the muscle thicker which will help prevent reflux. You can read more about the Stretta procedure here. This seems to be one of the best options for people with LPR.

Linx Procedure

If you didn’t know for a lot of people who suffer from both GERD and LPR the most common cause is because of the muscle above the stomach called the lower esophageal sphincter (LES) which doesn’t remain closed and tight when it should be to keep acid in the stomach. The Linx procedure aims to fix that. You can read more about the LES’s importance here – stomach sphincters role with LPR.

Basically, how it works is a small magnetic band is placed around the exact place of the LES – this magnetic band is designed to help the muscle close and tighten when it is meant to which helps prevent against reflux. The band will of course allow for swallowing and the foods to pass through normally as they should.

The Linx procedure is more invasive than the Stretta procedure though overall is still minimally invasive for a procedure thanks to the procedure being performed using a technique called laparoscopy (keyhole surgery). It’s also worth mentioning that this surgery is quite easily reversable if needed.

Nissen Surgery

If you didn’t know the full name for the Nissen surgery is the Laparoscopic Nissen fundoplication. Of these 3 options the Nissen is the most invasive and will typically need 4-5 small cuts in your abdomen to carry out the operation. This also means up to 2-3 months of time may be needed for healing with most patients being able to return to work after 2-3 weeks’ time.

How the Nissen surgery works is the top part of the stomach is wrapped around the lower part of your gullet which will form a collar. This process basically tightens the closing mechanism above the stomach which should prevent any acid from refluxing up into the esophagus. The Nissen surgery is reversable but as you would imagine it isn’t as simple as reversing the Linx procedure in comparison.

Frequently Asked Questions

How Long Does it Take For LPR to Heal?

It depends on a host of factors and it usually isn’t the same for everyone. If someone does an effective treatment like a low acid diet they can expect good results with some people being cured from that alone. Some people can see drastic improvements in under 2 weeks but for others it will perhaps take some months to see the same improvement. Additionally for others they may need to consider surgery though generally speaking that is quite rare. 

How Successful is Fundoplication Surgery?

Typically for this surgery people with GERD are the most common who have it done though of course for people with LPR it can also be effective. Long term results are much more detailed for people with GERD where the success rate shows 63% at a 20 year follow up. The same results are harder to find for LPR patients but it has also been proven to be successful for them as well. Here’s the study to back that up.

How is LPR Treated? (Most Effective Treatment for LPR)

LPR can be treated in a host of different ways. The best 2 options being a low acid diet where acidic foods of lower than pH 5 are avoided and trigger foods. You can read more about starting a diet for LPR here or for a complete diet plan check out the Wipeout Diet. For all treatment options check out this article – Silent Reflux Treatment.

Does Nissen Fundoplication Work for LPR?

Yes it does work but it won’t work for everyone. There was a study done which shows good results where most people had good results. You can check the study here.

Can You Burp After Fundoplication?

Yes you should be able to burp as normal after the fundoplication. Though there certain situations where difficulty burping and abdominal bloating can happen.

What Are The Side Effects of Nissen Fundoplication?

The most common side effects are difficulty swallowing, bloating, passing gas more often, struggling to burp and abdominal pain.

Is Fundoplication Surgery Painful?

Usually after the surgery you may be sore for a few weeks up until a couple of months after. Usually though most people can return to work after 2-3 weeks time when the pain has mostly subsided. For other people it may take up to 6 weeks to get back to their normal routine.

How Successful is Surgery for Acid Reflux?

Depending on the surgery results will vary but generally speaking the results are quite positive for more people than not. For people with LPR fundoplication is about 70% success rate, for people with GERD this is higher. For people with GERD Stretta has 64% success rate and for people with LPR it’s higher at over 80%. These are arguably the best 2 options for people with both LPR and GERD. You can read more about Stretta here

Is Acid Reflux Permanent?

No often it’s not. For some people it can be a simple or small thing triggering it which can easily be fixe. or For other people it may be troublesome but usually it can be controlled or at least kept at bay using some diet and lifestyle adjustments etc.

How Much Does Linx Surgery Cost?

It depends on a variety of things but the average cost is usually around $13,000 in the USA.

LPR Surgery Recovery Time – How Long?

It depends on the surgery option you have went for. With the fundoplication you can usually return to work 2-3 weeks after the operation, for the stretta you can return the following day and for the linx 5-14 days typically.

LPR Surgery Success Stories

There are plenty of success stories for people with LPR. I personally think for the highest chance of success the Stretta procedure is best for someone with LPR but the Fundoplication has also shown to be quite successful.

2 thoughts on “LPR Surgery – What Are Your Options?”

  1. Marcia Taraschi

    Hi David, I just found your blog and I think it’s great. I was wondering if you have had the Stretta procedure? I just had it done this past Wednesday. It went well but as you know it takes months to see if it has improved anything. I have had a chronic cough (everyday) for 26 years and similar to you saw many different types of doctors and tried may things until I figured out myself around 4 years ago that it was LPR. I found an excellent Dr that confirmed it and also determined I had vagus nerve dysfunction which explained why I have been so reactive to the pepsin irritation which is causing the daily coughing. I tried diet + reflux meds + meds for the cough/vagus nerve which helped but it never went away after many permutations. So here I am – immediately post Stretta and hopeful!

    1. Hi Marcia, thank you very much. I haven’t had the stretta but it definitely has helped a lot of people with our problems. As you know it can take some times for it to become effective so now you just need to be patient. It’s refreshing to speak to a doctor who understands things as this is not the norm as you said. Definitely send me an email, I’m interested to hear how you get on.

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