GERD or Gastroesophageal Reflux Disease can be treated with medications such as pump inhibitors (omeprazole, esomeprazole, etc.) or prokinetics (such as cinitapride, cisapride, etc.). However, in some cases, Antireflux Surgery is required to treat GERD. The most frequently performed antireflux surgeries are the Nissen Fundoplication and the Gastric Bypass or one of its modalities such as the SASI type Bypass. When should I consider having Antireflux Surgery to treat my GERD? 1.- When medications do not relieve my symptoms. 2.- When the medications do relieve my symptoms, but if I stop them the symptoms return, that is, I have to take medications for life. 3.- When I have respiratory symptoms or chest pain, because that indicates that my GERD is severe. 4.- When I have a previous endoscopy that says I have a large hiatal hernia, generally larger than 3 cm. 5.- When I have a previous endoscopy that reports moderate to severe Esophagitis or Barrett's Esophagus.