Stop Managing GERD — Start Treating It
Specialist GERD surgery in Novi & Southfield, MI. Our board-certified surgeons offer minimally invasive and robotic-assisted procedures that address the root cause of acid reflux — not just the symptoms.
What Is GERD? Understanding Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease — commonly known as GERD — is a chronic digestive condition in which stomach acid repeatedly flows backward into the esophagus. This happens when the lower esophageal sphincter (LES), the muscular valve at the base of the esophagus, becomes weakened or fails to close properly after swallowing.
Unlike the occasional heartburn most people experience after a large meal, GERD is persistent and progressive. Without proper treatment, repeated acid exposure can damage the lining of the esophagus and lead to serious long-term complications.
How Does GERD Develop?
Under normal conditions, the lower esophageal sphincter opens to allow food into the stomach, then closes tightly to prevent acid from escaping upward. In patients with GERD, this sphincter is too relaxed or too weak to maintain a proper seal — allowing stomach acid, bile, and partially digested food to rise into the esophagus and sometimes into the throat.
Over time, this repeated exposure wears down the esophageal lining, causing inflammation, ulcers, and structural changes that can become increasingly difficult to reverse without medical intervention.
What Happens If GERD Is Left Untreated?
Many patients manage GERD symptoms with over-the-counter medications for years — but ongoing acid exposure without proper treatment can lead to serious complications:
Barrett’s Esophagus
Precancerous changes to the esophageal lining caused by prolonged acid damage. Requires regular monitoring and may increase cancer risk.
Esophageal Stricture
Chronic inflammation causes scar tissue to narrow the esophagus, making swallowing increasingly painful and difficult.
Esophagitis
Persistent irritation of the esophageal walls, which can cause bleeding, ulcers, and a significant decrease in quality of life.
Recognizing the Symptoms of GERD
GERD presents differently from patient to patient. Some people experience primarily digestive symptoms, while others report respiratory or throat-related issues. The most common signs include:
Digestive & Chest Symptoms
- Persistent heartburn — a burning sensation in the chest, often worse after eating or when lying down
- Regurgitation of food, liquid, or sour-tasting acid into the mouth or throat
- Chest discomfort or a feeling of pressure behind the sternum
- Difficulty or pain when swallowing (dysphagia)
- A sensation of food being stuck in the throat or chest
Throat & Respiratory Symptoms
- Chronic dry cough with no clear respiratory cause
- Hoarseness, throat clearing, or a persistently sore throat
- Worsening asthma or new-onset wheezing
- Nausea, particularly after meals or in the morning
- Disrupted sleep due to nighttime reflux or coughing
Causes & Risk Factors for GERD
GERD develops when the lower esophageal sphincter is chronically weakened or under excess pressure. While anyone can develop GERD, certain conditions and lifestyle factors significantly increase your risk:
Medical & Physical Factors
- Being medically overweight or obese — excess abdominal weight places constant upward pressure on the stomach
- Pregnancy — hormonal changes relax the LES, and the growing uterus creates added abdominal pressure
- Hiatal hernia — a structural condition where part of the stomach pushes into the chest cavity, impairing the LES
- Connective tissue disorders that affect sphincter muscle function
Lifestyle & Medication Factors
- Smoking or frequent exposure to secondhand smoke — nicotine weakens the LES
- Certain medications including asthma inhalers, antihistamines, sedatives, antidepressants, and calcium channel blockers
- Diets high in fatty, spicy, or acidic foods, as well as caffeine and alcohol
- Eating large meals or lying down shortly after eating
How Is GERD Diagnosed?
Diagnosing GERD begins with a thorough review of your symptoms and medical history. In many cases, a clinical evaluation is sufficient for an initial diagnosis. However, to fully assess the severity of the condition and rule out complications, one or more of the following diagnostic tests may be recommended:
Upper Endoscopy (EGD)
A thin, flexible camera is guided into the esophagus and stomach to directly visualize the lining, assess damage, and screen for complications such as Barrett’s esophagus or strictures.
Ambulatory pH Monitoring
A small sensor measures acid levels in the esophagus over 24–48 hours, providing an objective record of how frequently reflux occurs and its correlation with symptoms.
Esophageal Manometry
Measures the pressure and function of the esophageal muscles and lower esophageal sphincter. Particularly important for evaluating patients considering surgical treatment.
Barium Swallow X-Ray
The patient swallows a contrast liquid that coats the esophagus and stomach, making structural abnormalities — including hiatal hernias — visible on X-ray imaging.
GERD Treatment Options in Novi & Southfield, MI
Treatment for GERD is individualized based on the frequency and severity of your symptoms, diagnostic findings, and personal health goals. At Kolachalam Surgery, we take a stepwise approach — beginning with conservative measures and advancing to surgical intervention when needed.
Lifestyle Modifications
First-line approach for mild to moderate GERD
For mild to moderate GERD, targeted lifestyle changes can substantially reduce or eliminate symptoms without medication:
- Eat smaller, more frequent meals throughout the day rather than two or three large ones
- Allow at least three hours between your last meal and bedtime to give the stomach time to empty
- Elevate the head of your bed by 6–8 inches to use gravity to keep acid down overnight
- Maintain a healthy body weight — even modest weight loss can significantly reduce LES pressure
- Avoid wearing tight-fitting clothing around the waist, which increases abdominal pressure
- Eliminate or reduce known trigger foods: alcohol, caffeine, spicy dishes, fried food, citrus, and tomato-based products
- Quit smoking — nicotine is a direct contributor to LES weakness
- Sleep on your left side, which has been shown to reduce nighttime reflux episodes
Medications
When lifestyle changes alone are insufficient
Your provider may prescribe medication to reduce acid production and manage symptoms:
Antacids
Provide rapid but temporary relief by neutralizing existing stomach acid. Best used for occasional, mild symptoms rather than daily management.
H2 Receptor Blockers
Reduce the amount of acid the stomach produces over several hours. Helpful for moderate symptoms and nighttime reflux relief.
Proton Pump Inhibitors (PPIs)
The most effective class of acid-suppressing medications. PPIs block acid production at the source and are commonly prescribed for persistent or erosive GERD.
Surgical Procedures for GERD in Novi, MI
For patients whose symptoms persist despite medication and lifestyle changes — or who prefer a long-term solution over indefinite medication use — surgery offers the most durable and definitive treatment available. Our surgeons specialize in two highly effective, minimally invasive GERD surgical procedures.
When Is GERD Surgery Recommended?
You may be a candidate for GERD surgery if you experience one or more of the following:
- Ongoing symptoms despite consistent use of prescription-strength medications
- Long-term reliance on proton pump inhibitors or H2 blockers
- Diagnosis of a hiatal hernia contributing to reflux
- Complications such as Barrett’s esophagus, esophagitis, or esophageal stricture
- Inability to tolerate GERD medications due to side effects
- Personal preference to avoid lifelong medication dependence
Procedure 1
Laparoscopic Nissen Fundoplication
The Gold Standard in GERD Surgery
Nissen fundoplication is the most established and widely performed surgical procedure for GERD. During this minimally invasive laparoscopic procedure, the upper portion of the stomach (the fundus) is wrapped around the lower esophagus and secured in place. This reinforces the lower esophageal sphincter, creating a durable physical barrier that prevents stomach acid from refluxing upward.
The procedure is performed through several small incisions using a laparoscope and specialized instruments — no large open incision is required. Most patients go home within one to two days and return to light activities within one to two weeks.
- Clinically proven with decades of data supporting long-term effectiveness
- Eliminates or greatly reduces the need for daily acid-suppressing medications
- Minimally invasive — small incisions, less pain, faster healing
- Short hospital stay — typically one to two nights
- Addresses both GERD and associated hiatal hernia in a single procedure
Procedure 2
Robotic-Assisted GERD & Hiatal Hernia Repair
Advanced Precision for Complex Cases
Dr. Kolachalam has performed over 1,200 Da Vinci robotic surgical procedures, making Kolachalam Surgery one of the most experienced robotic surgery practices in the Novi and Southfield, MI region. For GERD surgery, robotic-assisted technology offers surgeons enhanced three-dimensional visualization and greater instrument precision compared to conventional laparoscopy.
This approach is particularly well-suited for complex cases, recurrent hernias, or patients whose anatomy requires a more refined surgical technique. The robotic platform allows for the same proven fundoplication or hernia repair procedure — with added precision and control.
- Superior visualization and surgical precision through robotic technology
- Smaller incisions and reduced postoperative discomfort
- Faster return to normal daily activities
- Ideal for complex, recurrent, or anatomically challenging cases
- Performed by a surgeon with 1,200+ robotic procedure experience
Procedure 3
Endoscopic Procedures for GERD
Minimally Invasive Non-Surgical Option
For select patients, endoscopic treatment may offer an alternative to traditional surgery. These procedures are performed through the mouth using a flexible endoscope — no incisions required.
- Radiofrequency Ablation (Stretta Procedure) — Controlled radiofrequency energy is applied to the lower esophageal sphincter to stimulate tissue tightening and reduce the frequency of reflux episodes.
This outpatient procedure is well-tolerated and can provide meaningful symptom relief for appropriately selected patients. Our surgical team will evaluate whether an endoscopic approach is suitable for your specific condition during your consultation.
Why Choose Kolachalam Surgery for GERD Treatment?
Patients throughout Novi, Southfield, Farmington Hills, West Bloomfield, Northville, and Plymouth choose Kolachalam Surgery for specialist-level GERD care. Here is what distinguishes our practice:
Meet Our Surgical Team
Our practice is led by two board-certified surgeons with deep expertise in minimally invasive abdominal and hiatal hernia surgery, committed to delivering state-of-the-art care with a compassionate, patient-first approach.
Dr. R.B. Kolachalam, MD
Board-Certified General Surgeon | Section Chief, Department of General Surgery, Providence Hospital
Dr. Kolachalam has been a board-certified surgeon serving the Novi and Southfield, MI area since 1995. He serves as Section Chief of the Department of General Surgery at Providence Hospital and as a Clinical Associate Professor in the Department of Surgery at Michigan State University. He practices at both Providence Hospital and St. Mary’s Hospital, where he also serves as part of the teaching faculty.
His primary areas of expertise include minimally invasive abdominal surgery, Da Vinci robotic surgery, endocrine surgery (thyroid, parathyroid, and adrenal glands), and Hyperbaric Oxygen Therapy (HBOT). He is dedicated to providing state-of-the-art surgical, diagnostic, and treatment technology alongside personalized, compassionate patient education.
- Over 1,200 Da Vinci robotic surgical procedures performed
- Board-certified surgeon since 1995
- Section Chief, Department of General Surgery — Providence Hospital
- Clinical Associate Professor, Department of Surgery — Michigan State University
- HOUR Detroit Magazine Top Doc — every year from 2011 to 2019
- Patients’ Choice Award recipient, 2010–2013 (awarded to only the top 5% of physicians nationwide)
- Serving Farmington Hills, West Bloomfield Township, Northville, Plymouth, Redford Charter, and surrounding areas
Dr. Elizabeth Tindal, MD, MPH
Board-Certified General Surgeon | Specialist in Minimally Invasive GI, Bariatric & Foregut Surgery
Dr. Elizabeth Tindal is a board-certified surgeon with advanced training in minimally invasive gastrointestinal, bariatric, and foregut surgery. She earned her medical degree and Master of Public Health from Drexel University, completed her general surgery residency at Brown University, and pursued fellowship training at Lenox Hill Hospital in New York City.
Dr. Tindal cares for patients with a wide range of conditions, including hiatal hernias, gastroesophageal reflux disease, gallbladder disease, inguinal and ventral hernias, and complex abdominal wall reconstruction.
- Medical Degree & Master of Public Health (MPH) — Drexel University
- General Surgery Residency — Brown University
- Fellowship Training in Minimally Invasive Surgery — Lenox Hill Hospital, New York City
- Specialties: Hiatal hernia, GERD, bariatric surgery, abdominal wall reconstruction
“Her goal is to provide compassionate, individualized care, using minimally invasive techniques whenever possible to help patients heal faster and return to their daily lives.”
Frequently Asked Questions About GERD Surgery
What is the difference between heartburn and GERD?
Heartburn is a symptom — a burning sensation in the chest caused by stomach acid briefly entering the esophagus. GERD is a chronic medical condition in which this reflux occurs regularly (typically two or more times per week) and causes measurable damage to the esophagus over time. Heartburn can be a symptom of GERD, but not everyone with heartburn has GERD.
How do I know if I need surgery for GERD?
Surgery is generally recommended when symptoms persist despite appropriate medication and lifestyle changes, when a structural problem such as a hiatal hernia is contributing to reflux, or when long-term medication use is not a preferred option. Our team conducts a comprehensive evaluation — including endoscopy and reflux testing — to determine whether surgery is the right choice for you.
Is GERD surgery safe?
Yes. Laparoscopic Nissen fundoplication and robotic-assisted GERD surgery are well-established procedures with strong safety profiles. Performed by an experienced surgeon, these minimally invasive approaches carry significantly lower risks than open surgery and have decades of clinical data supporting their effectiveness and durability.
What is recovery like after GERD surgery?
Most patients are discharged within one to two days following surgery. A soft or liquid diet is typically recommended for the first few weeks while the esophagus heals. The majority of patients return to desk work within one to two weeks and resume full normal activity within four to six weeks. Our team provides detailed recovery guidance and attentive follow-up care throughout your healing process.
Will I still need medication after GERD surgery?
The majority of patients are able to significantly reduce or completely discontinue their acid-suppressing medications after a successful fundoplication. Long-term outcomes vary by individual, and your surgeon will monitor your progress carefully during follow-up visits to ensure the best possible result.
Can GERD come back after surgery?
While fundoplication has excellent long-term success rates, a small percentage of patients may experience a recurrence of symptoms over time — particularly if significant lifestyle changes are not maintained. Our team will provide guidance on dietary habits, weight management, and other factors that support lasting surgical outcomes.
Does insurance cover GERD surgery?
Most major insurance plans cover GERD surgery when clinical criteria are met and appropriate diagnostic testing has been completed. Our billing team will verify your coverage, explain any out-of-pocket costs, and walk you through available financing options before any procedure is scheduled.
Can GERD cause cancer?
Untreated, chronic GERD can lead to Barrett’s esophagus — a precancerous change in the esophageal lining that increases the risk of esophageal adenocarcinoma. This is one of the most important reasons to seek proper evaluation and treatment rather than relying on over-the-counter medications indefinitely. Regular monitoring and timely treatment significantly reduce this risk.
This content has been reviewed by a Board-Certified General Surgeon in Novi and Southfield, MI.