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Comparison of GERD Treatment Options

In general, if one pill a day controls heartburn and reflux symptoms, the patient has no upper-airway symptoms that are due to GERD, and the patient takes supplemental calcium and has bone density monitored, and the medication is affordable, it seems reasonable to say that PPI therapy is the safest way to manage that patient's GERD.
However, if:
-increasing doses are needed, or
-patients are having to switch medications because one is not working,or
-heartburn, reflux, or other GERD symptoms persist despite taking medication, or
-upper airway or laryngeal symptoms are due to non-acid reflux, or
-the patient is already at high risk for osteoporosis,
then strong consideration should be given to procedures to repair the antireflux valve - the Laparoscopic Fundoplication or the EsophyX Transoral Incisionless Fundloplication.