I had surgery for reflux & hiatel hernia in Jan this year - I now have my voice back which had been affected by the acid. I would recommend this surgery to anyone who has tried all other avenues. Ask for a surgeon who has a high success rate with this Nissen surgery. There are side-effects which will affect your life style so ask about them(unable to burp or vomit,no soda or beer, smaller meals etc) I was on a medication which had to be increased because it became ineffective, tried another which also had to be increased (4 pills a day). I was diagnosed with "upright" reflux which only 2% of the patients have, my reflux occured when I was standing or sitting - not laying down. Good Luck (I had my surgery done at a teaching hospital).