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Acid Reflux / GERD


Heartburn is the most common symptom of GERD, but you may also experience:

  • Esophogeal problems
    • Pain or discomfort in the chest
    • Difficulty swallowing
  • Lung problems
    • Asthma-like symptoms
    • Chronic cough
  • Throat problems
    • Hoarseness or voice changes
    • Constant throat clearing
    • Frequent swallowing


X-ray studies

An upper GI studdy (UGI) shows the anatomy of the esophagus & stomach and can demonstrate reflux in real time.

Endoscopy (EGD)

A flexible fiberoptic scope is used to directly examine the lining of the esophagus and stomach. This can demonstrate a hernia, acid injury and other diseases.

pH Study

During endoscopy, a small device called a BRAVO probe, can be placed in the esophagus to measure and record acid levels for 48 hours.


Laparoscopic Surgery

Most cases of reflux are due to the stomach herniating above the diaphragm into the chest, a condition called Hiatal Hernia. This hernia can be repaired with advanced laparoscopic surgery.

Transoral Incisionless
Fundoplication (TIF)

TIF, or Transoral Incisionless Fundoplication, is an incisionless surgical procedure in which the stomach is wrapped around the lower end of the esophagus and sutured in place as a treatment for the reflux of stomach contents into the esophagus. It offers less pain, less risk, no scars and most patients can get back to work and most normal activities in just a couple of days.

Nissen Fundoplication

Nissen Fundoplication is a surgical procedure in which part of the stomach is wrapped 360 degrees around the lower end of the esophagus and stitched into place to prevent or treat concurrent hiatal hernia.


A nonsurgical procedure is used to examine a person’s digestive tract through an endoscopy. Using a flexible tube with a light and a camera called endoscope, the doctor can view pictures of your digestive tract.

Reasons to have an Endoscope done are:

  • Reflux
  • Stomach pain
  • Ulcers, gastritis, or difficulty swallowing.
  • Digestive tract bleeding
  • Changes in bowel habits
  • Polyps or growth in the colon

Additionally, your doctor might use an endoscope to remove tissue or biopsy for presence of disease.


The TIF procedure is performed safely, quickly and in the minimal time possible. This procedure is performed under general anesthesia and with laparoscopic procedure in most cases; the device is introduced into the body through the mouth and unto the esophagus. The device then forms and fastens a fold recreating its normal anatomy. This procedure has been proven to be safe and has been performed on many patients worldwide. if you want to see an animated version of the procedure


During this procedure, the upper part of the stomach is wrapped around the esophagus and sewn into place. This surgery will strength the valve preventing the acid from coming back up. A general anesthetic is used and there is less pain involved.


Similar to the NISSEN procedure, the Toupet laparoscopic fundoplication, only folds to a 270 °; whereas the NISSEN procedure folds to a 360°.


A hiatal hernia is when the thin muscle in the diaphragm is weakened, letting the stomach move up the diaphragm and into the chest making the area between the stomach and esophagus less competent and more likely to allow the reflux acid into the esophagus.

Why Hillcrest General Surgery?

As a part of Hillcrest Baptist Medical Center, Scott & White Healthcare, Hillcrest General Surgery in Waco, Texas strives to provide excellence in patient care through providing comprehensive general surgery services in the Central Texas Area.