Most of the time, LPR is well controlled with medications called Proton Pump Inhibitors (PPI). Occasionally, surgery is needed in severe cases or those that don’t resolve with medications. The recommended surgery is called a Laparoscopic Nissen Fundoplication, and is performed by a General Surgeon. Positive proof of reflux disease is needed first, generally by a pH probe study. With some patients, the esophagus (swallowing tube) must also be examined for pre-malignant changes.