Skip to main contentDr. Jivraj Mehta Hospital · Vasna, Ahmedabad
GERD and reflux disease treatment in Ahmedabad · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Most people with heartburn and sour regurgitation never need an operation, and many never need a single test. Typical reflux without warning signs is treated first with a well-timed acid-reducing tablet for about two months and a few changes to meals and sleep. Tests are kept for the people they help: anyone with a warning sign, anyone whose symptoms do not settle on tablets taken correctly, and anyone who is thinking about surgery. An anti-reflux operation is offered only when reflux has been proven on tests, never on symptoms alone.
Reflux care runs from the dining table to the operating theatre, and most patients stop on one of the first steps. The same practice gives the first prescription, performs the endoscopy, arranges the acid and pressure studies, treats the conditions that imitate reflux, stretches a narrowing when one forms, and operates when an operation is right — so no step is skipped and none is taken too early.
Dr. Jivraj Mehta Hospital. Trained in super-specialty surgical gastroenterology programmes, qualified twice over in the specialty, with 18 years of experience in surgery of the food pipe and stomach. Endoscopy, reflux and pressure studies, medical treatment, dilation of narrowings, keyhole anti-reflux surgery and long-term follow-up sit within one practice.
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Food Pipe Surgeon · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Google rating 4.94 from 18 reviews at Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad.
Gastro-oesophageal reflux disease, usually shortened to GERD, means that stomach contents — acid, and sometimes bile and food — flow back up into the food pipe often enough to cause symptoms or damage. A small amount of reflux happens in everyone. It becomes a disease when it burns, when food or sour fluid comes back into the mouth, when it wakes you at night, or when it injures the lining of the food pipe. The valve at the lower end of the food pipe may relax too often, may be weakened by a hiatus hernia (part of the stomach slipping up through the diaphragm), or the food pipe may be slow to clear what comes back.
Heartburn and regurgitation that are worse after meals or on lying down are the classic pair. Chest pain, a cough lasting more than two months, a hoarse voice, a constant lump in the throat and worn teeth can also come from reflux — but they have other causes too, and none of them is ever operated on without proof that reflux is the cause.
Chest pain is the one symptom that is never assumed to be acid. The heart is checked first, every time, before chest pain is put down to reflux. Long-standing indigestion with weight gain around the middle often turns out to be reflux. A cough, throat-clearing or hoarseness may improve on reflux treatment, but these “throat” symptoms are the ones most often blamed on reflux wrongly, which is why they need objective tests before any decision about surgery.
Difficulty swallowing, pain on swallowing, weight loss without trying, anaemia or black stools, repeated vomiting, and new symptoms beginning at fifty-five or older are warning signs. Any one of them means an endoscopy first, within about two weeks — not a trial of tablets.
These signs matter because they can point to a narrowing, an ulcer, bleeding or, uncommonly, a growth in the food pipe or stomach. An endoscopy settles the question directly, and it is far better to look early than to hide a serious cause under months of acid tablets. Food sticking suddenly, so that even saliva will not go down, is a same-day problem: it needs prompt endoscopy to clear the blockage.
Typical reflux without warning signs needs no test at the start: if a two-month course of tablets works, nothing more is required. If the tablets fail, the symptoms are unusual, or surgery is being considered, three tests are done together — an endoscopy, a twenty-four-hour acid and reflux study off tablets, and a pressure study of the food pipe. A barium swallow is added only for selected patients.
| Step | Test | What it decides |
|---|---|---|
| Start — typical symptoms, no warning sign | No test; an eight-week course of tablets | If symptoms settle, the diagnosis is made and no further test is needed |
| Warning sign present | Endoscopy first, within about two weeks | Excludes a narrowing, ulcer, bleeding source or growth; biopsies as needed |
| Tablets fail, unusual symptoms, or before any operation | Endoscopy (if not already done) | Grade of inflammation, size of any hiatus hernia, how well the valve closes, Barrett’s change, biopsies if another inflammation is suspected |
| Same group | Twenty-four-hour pH-impedance study, with acid tablets stopped for a week beforehand | Whether acid really reaches the food pipe often enough, and whether symptoms line up with reflux episodes |
| Same group | High-resolution manometry (pressure study) | Whether the food pipe squeezes normally — this excludes achalasia and guides the type of wrap |
| Selected patients only | Barium swallow | Shape and size of a large hiatus hernia, a suspected rolling (paraoesophageal) hernia, or planning a repeat operation |
The acid study is done off tablets because the question is whether reflux exists, not whether the tablets are suppressing it. The pressure study matters for two reasons: some people sent for “reflux surgery” turn out to have achalasia, a different disease in which a wrap would make swallowing worse, and the strength of the food pipe’s squeeze decides whether a full or a partial wrap is safer.
The tests sort patients into groups that are treated very differently. Severe inflammation, a reflux narrowing, Barrett’s change confirmed on biopsy, or clearly excess acid on the study prove reflux disease. A normal acid study points instead to a sensitive food pipe or to functional heartburn — real, uncomfortable conditions, but not ones that an operation helps.
| Finding | What it means | Is surgery ever considered? |
|---|---|---|
| Severe erosive inflammation, a reflux narrowing, or confirmed Barrett’s change | Reflux disease is proven | Yes, if the other conditions for surgery are met |
| Clearly excess acid on the twenty-four-hour study | Reflux disease is proven | Yes, if the other conditions are met |
| Borderline acid result | Uncertain — supporting measurements are needed before any decision | Only after the extra evidence agrees |
| Normal acid, but symptoms match the episodes that do occur | Reflux hypersensitivity — a sensitive food pipe | No |
| Normal acid, symptoms unrelated to episodes | Functional heartburn | No |
Most “tablet-resistant reflux” turns out, once tested, to be something else: functional heartburn, a sensitive food pipe, eosinophilic inflammation, achalasia, or a habit of effortless regurgitation called rumination. Each of these has its own treatment. A wrap would not help any of them, which is why proof comes before an operation and not after.
Reflux disease is benign. The work-up is built to catch the uncommon cases where it is not: a growth in the food pipe or stomach producing the same symptoms, or Barrett’s change in the lining, which needs regular endoscopic checks. That is why warning signs go straight to endoscopy, why every narrowing is biopsied before it is stretched, and why Barrett’s surveillance continues even after a successful operation.
Barrett’s change is a long-term reaction of the lining to acid. It is found at endoscopy and confirmed on biopsy. If biopsies show abnormal cells (dysplasia), the right treatment is endoscopic removal or ablation of that lining on a separate pathway, not an anti-reflux operation. If they do not, the patient is booked for repeat endoscopy at intervals set by the length of the Barrett’s segment. An operation controls reflux; it does not remove the need for these checks.
Treatment climbs one rung at a time, and most people stop on the first or second. The first rung is meal and sleep changes with a standard tablet for eight weeks; the second strengthens the medicine; the third is testing when tablets fail; the fourth treats what the tests actually find; and the last rung, an operation, is only for proven reflux in the right patient.
| Rung | What it involves | Who stops here |
|---|---|---|
| First — habits and a standard tablet | Weight loss if overweight, raising the head end of the bed, the last meal at least three hours before lying down, stopping smoking; a standard-dose acid-reducing tablet (proton-pump inhibitor) taken half a hour to a hour before breakfast for eight weeks | Most people with typical reflux |
| Second — a stronger medical plan | The tablet twice a day before breakfast and dinner; an alginate liquid after meals for regurgitation; a night-time tablet of another class for night-time breakthrough; or a newer acid blocker (vonoprazan) for partial responders | Many of those who respond only partly |
| Third — test when tablets fail | After eight weeks of the stronger plan, taken correctly: endoscopy, acid study off tablets, pressure study | Everyone whose symptoms persist |
| Fourth — treat what the tests find | A pain-modulating medicine for a sensitive food pipe or functional heartburn; specific treatment for eosinophilic inflammation, achalasia or rumination; stretching of a reflux narrowing with lifelong acid control | Those whose symptoms are not reflux, or not only reflux |
| Fifth — anti-reflux operation | A keyhole fundoplication (a wrap of stomach around the lower food pipe) with repair of any hiatus hernia; in selected patients a magnetic ring | Proven reflux plus a clear reason to operate |
Two details decide whether the first rungs work. Timing: an acid-reducing tablet works properly only when taken thirty minutes to a hour before the first meal, not after it and not at bedtime. Adherence: a course taken only on bad days is not a trial of treatment. Before anyone is called a non-responder, the dose, the timing and the daily habit are checked.
Surgery is not needed for most reflux. It is not offered when reflux has not been proven on tests, when the acid study is normal, when symptoms come from a sensitive food pipe or functional heartburn, when the food pipe does not squeeze properly because of achalasia or scleroderma, or when weight is very high — in which case a weight-loss bypass, not a wrap, is the reflux operation.
Many people who are well controlled on tablets also do not need surgery and can safely stay on them. The long-term safety concerns raised about acid-reducing tablets come from observational studies — bone thinning, low vitamin B12 or magnesium, a particular bowel infection. They are discussed in proportion, and a tablet is never stopped in someone who needs it. In milder disease and in healed mild inflammation, the dose can often be stepped down, or taken only when needed, under supervision.
Some patients come for surgery because their main symptom is a cough or a hoarse voice. These are the people for whom proof matters most: without objective evidence that reflux is reaching the food pipe, no operation is advised for throat symptoms, however long they have lasted.
An operation is considered when reflux has been proven on tests and at least one of these applies: you depend on tablets and want to stop them; regurgitation keeps going despite tablets; you cannot tolerate the tablets; a large hiatus hernia is causing symptoms; or a cough or hoarseness has been shown, on testing, to follow reflux episodes.
Every surgical candidate is discussed with the endoscopy, acid and pressure results side by side. All three tests are required before an operation, with no exceptions, because the commonest reason for a disappointing result after reflux surgery is operating on someone who did not have reflux in the first place.
The operation is chosen to fit the food pipe and the hernia. With normal squeezing, a full wrap or a partial wrap are both reasonable and the choice is shared with the patient. With weak squeezing, a partial wrap at the back is safer. A larger hernia is repaired by closing the gap in the diaphragm along with the wrap.
| Situation | Usual operation |
|---|---|
| Normal food pipe squeeze, classic reflux | Keyhole full wrap (Nissen) or partial wrap (Toupet) — a shared decision |
| Weak or borderline squeeze | Keyhole partial wrap at the back (Toupet) |
| Larger hiatus hernia | Closure of the gap in the diaphragm plus a wrap; mesh only selectively for a very large or recurrent hernia |
| Small hernia, normal squeeze, wish to avoid bloating | Magnetic ring (LINX) — rarely available and costly in India, so seldom used |
| Reflux with very high body weight | Gastric bypass as the reflux operation, never a sleeve |
| After an operation for achalasia | A partial front wrap (Dor) |
Whatever the type, the standards are the same. The hernia is fully freed so that enough food pipe lies comfortably inside the abdomen without tension, both vagus nerves are protected, the gap in the diaphragm is closed with permanent stitches, and the wrap is kept short and loose and stitched so it cannot slip. The operation is done through keyhole incisions.
Preparation focuses on what protects the repair: stopping smoking at least two weeks before, losing weight where possible, and treating constipation and chronic cough, which strain the stitches. Most patients walk and sip clear fluids the same evening, take liquids the next day and go home on the first day after an uncomplicated keyhole wrap.
Retching in the first day or two is the one thing that threatens a new wrap, so anti-sickness medicines are given generously before, during and after the operation. No nose tube and no drain are needed routinely. At home, a soft and sloppy diet in small, frequent meals is kept for about two weeks — no bread, dry rice or fizzy drinks — and normal food returns gradually over the next few weeks. Heavy lifting is avoided for six weeks.
Some difficulty swallowing in the first weeks is expected and usually settles; patients are told this in advance so that it does not come as a worry. Retching or vomiting, chest pain with fever, a racing pulse, or being unable to swallow even saliva are reasons to call the team at once.
★★★★★
“Excellent doctor. I have undergone Surgery for toupet fundoplication with harsh Shah doctor. Sir has given good treatment for early recovery. Treating patients very friendly. — Ravi Bob, Google review”
★★★★★
“He is simple and straight conversation person. Explains the procedure and process to prepare the patient mentally for the surgery which makes patients comfortable during the process. He is also very patient enough to hear all problems of his patients which makes him an approachable doctor. — palak thareja, Google review”
★★★★★
“Dr. Harsh Shah is an excellent doctor who handled our case with great diligence and care. He listens attentively and addresses every concern with utmost patience. He's very humble and answers all of your questions in detail which is very assuring. I would highly recommend Dr. Harsh Shah for consultation and treatment. — Srinath Vasudevan, Google review”
Real Google reviews from Dr Harsh Shah’s two listings, reproduced exactly as written.
Anti-reflux surgery is a planned, low-risk operation, but it has real risks, and three after-effects deserve to be known in advance: swallowing difficulty in the early weeks, bloating with difficulty belching, and the chance that some reflux returns over the years. Dr Harsh Shah gives the figures for each at the consent discussion, adjusted for the size of the hernia, age, weight and any earlier operation.
The general risks of any operation include bleeding, wound infection, clots in the leg or lung, heart strain, anaesthetic problems and the need to change from keyhole to open surgery. The specific risks are swallowing difficulty that lasts and needs stretching or revision, gas-bloat, slipping or herniation of the wrap that may need a repeat operation, injury to the food pipe or stomach, injury to the vagus nerves slowing stomach emptying, air around the lung, and injury to the spleen. Over the long term some patients need an acid tablet again; before restarting tablets for good, the reflux is re-tested, because new symptoms are not always returning reflux.
After surgery the checks are at two weeks (wound, diet and swallowing), six weeks (back to normal food and activity, routine acid tablets stopped) and between six and twelve months (symptoms and quality of life), then once a year. Endoscopy is repeated only for symptoms — or on the fixed schedule that Barrett’s change requires.
Patients who stay on medical treatment are reviewed to keep the dose as low as works. Anyone with a reflux narrowing stays on lifelong acid control and is re-stretched if swallowing tightens again. Anyone with Barrett’s change keeps their endoscopy appointments whether or not they have had an operation.
Medical treatment costs only the consultation and the tablets. The cost of the work-up depends on which tests are needed. The cost of surgery depends on the type of wrap, whether a hernia needs repair or mesh, and the length of stay. A written estimate is given and explained before any test or operation.
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad, works with the major insurers and cashless schemes, and the office handles pre-authorisation directly. A magnetic ring is rarely covered by insurance or government schemes, and its cost is discussed openly if it is ever an option.
Bring: every endoscopy report and photograph, any pH or manometry report, barium swallow images, a list of every reflux tablet you have taken with doses and timing, a list of all other medicines, any heart test done for chest pain, the insurance card and identification.
Not if your symptoms are typical heartburn and regurgitation with no warning sign. An eight-week course of tablets comes first, and if it works no test is needed. Difficulty or pain on swallowing, weight loss, anaemia, black stools, repeated vomiting or new symptoms at fifty-five or older mean an endoscopy first.
Possibly not. These tablets work properly when taken half a hour to a hour before breakfast, every day. The timing and daily habit are checked first; if symptoms persist on a correctly taken stronger plan, the tests are done.
The study asks whether reflux exists, not whether the tablets are hiding it. Taken off tablets, it shows how much acid really reaches the food pipe and whether your symptoms match the reflux episodes.
For proven reflux in the right patient, a wrap often lets people stop daily tablets, though some need one again over the years. Before restarting tablets long term after surgery, the reflux is re-tested.
Only if tests prove that reflux reaches the food pipe and that the cough follows it. Without that proof, no operation is advised for cough or hoarseness.
No. The operation controls reflux; Barrett's surveillance endoscopy continues on its own schedule afterwards.
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Google: Dr Harsh Shah · 4.94 from 18 reviews
Directions to Dr. Jivraj Mehta Hospital, Vasna · WhatsApp +91-63555-64601
Patients come to Ahmedabad for reflux care and food pipe surgery from across Gujarat — Gandhinagar, Mehsana, Banaskantha, Nadiad, Anand, Bhavnagar, Rajkot, Jamnagar and Kutch — and from southern Rajasthan and western Madhya Pradesh.
Still burning after months of acid tablets, or told you may need reflux surgery? The endoscopy report and photographs, any pH or manometry study, and the list of tablets you have tried (with doses and timing) can be sent ahead of the appointment, so the consultation starts with them already read; treatment is decided at the consultation, after examination. Call +91-63555-64601 · Send the reports ahead on WhatsApp
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