Severe GERD Conditions

What is Severe GERD?

Severe GERD occurs when various conditions result from or complicate basic GERD. Hiatal hernias are one of the most common conditions that may contribute to Severe GERD. 80% of people with pathological acid reflux have a hiatal hernia. A hiatal hernia is a weakness in the muscle between the chest and the abdomen, called the diaphragm, where the stomach slips up above the diaphragm.

What Causes Severe GERD?

Hiatal hernias are fairly common, and many patients with basic GERD and a small hiatal hernia may not develop Severe GERD if they have a strong LES. But when a large hiatal hernia is combined with a weak LES, it may cause Severe GERD.

The combination of a large hiatal hernia with a weak LES creates a siphoning effect in the body. This effect takes place because the pressure in the chest is negative and the pressure in the abdomen is positive. This destructive pressure gradient is often especially evident at night or when laying down.


Symptoms of Severe GERD often include the symptoms of regular GERD, which generally include indigestion, heartburn, regurgitation, and sore throat. However, symptoms of Severe GERD may also include:

  • Dysphagia, or trouble swallowing
  • Aspiration
  • Anemia
  • Cancerous Ulcers
  • Choking
  • Persistent Sinusitis or Pneumonia

Recurring symptoms of Severe GERD are the earmark of a Failed Antireflux Surgery. These symptoms may include choking, coughing, aspiration, pneumonia, asthma, voice changes, recurrent sinusitis. These symptoms will be particularly worse at night.

How is Failed Antireflux Surgery treated?

Failed Antireflux Surgery symptoms may not respond to currently available GERD medication, which treats GERD by neutralizing or reducing the amount of stomach acid. This is because people with Severe GERD reflux not only acid, but bile, pancreatic juices, and whatever else is in their stomach. In some cases, patients may not be able to or want to take existing medications. In patients with Failed Antireflux Surgery, surgery may be the best treatment option.