In this episode of All Four Guts, Dr. Waseem Skef leads a nuanced discussion on reflux symptoms after fundoplication surgery. Joined by Dr. Daniel Tseng and Dr. Yan Jang, the panel explores why symptoms like heartburn and regurgitation may return years after surgery—and how to tell whether it's a true surgical failure or something else entirely. Topics include when to reintroduce PPIs, interpreting diagnostic tests (like wireless pH vs. catheter testing), surgical revision thresholds, and the role of BMI, motility, and gastroparesis in decision-making. Whether you're managing a single patient or shaping a care pathway, this episode offers practical insights from both sides of the scope. 

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