Why a 360-degree stomach wrap might stop your reflux—and your burps

Health · Published 20 October 2026 Swipe more like this →

In short: When acid reflux becomes chronic, surgeons can physically remodel your anatomy. By wrapping the top of your stomach around your food pipe, they create a new valve. But this mechanical fix comes with a trade-off: while it keeps acid down, it can also trap gas inside your stomach.

A Nissen fundoplication is a surgical intervention for patients whose gastro-oesophageal reflux disease (GORD) remains severe despite medication and lifestyle changes. The procedure addresses two primary issues: the malfunctioning muscle valve (sphincter) between the esophagus and the stomach, and hiatal hernias. Up to 20% of individuals suffer from a hiatus hernia, a state where the stomach moves into the thoracic cavity because the diaphragmatic gap has expanded excessively.

The surgery typically involves two distinct mechanical steps. First, the surgeon strengthens the weakened muscle of the hiatus using stitches or reinforcement material, which the body eventually replaces with scar tissue. Second, the surgeon performs the 'wrap.' In a full Nissen fundoplication, the top part of the stomach (the fundus) is wrapped 360 degrees around the lower esophagus to create a new, tighter valve. Alternatives exist for specific needs: the Toupet wrap covers 270 degrees of the back side to allow for easier burping, while the Dor wrap covers only the front half (180 degrees) and is often used for conditions like achalasia.

While the procedure is highly effective at reducing acid reflux and lowering the risk of developing Barrett’s esophagus, it is not without complications. Because the new valve is so robust, it can reduce the ability to belch or vomit, potentially leading to trapped gas and bloating. In rare cases, the wrap may slip or become too loose, requiring a repeat operation. Surgery is generally performed via 'keyhole' (laparoscopic) techniques using 4 to 6 small incisions, though less than 1 in 100 cases require conversion to a larger open incision.

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