Hi.. in the report there’s no mention of hiatus hernia...if there’s hiatus hernia considering young age surgery is the best option as it’s only way to get back normal anatomy and give permanent solution If reflux is there without hiatus hernia.. always medical treatment should be tried for 3-6months minimum.. pts who respond to medical tx will have high success rate after surgery . Anti reflux surgery is a day care procedure with almost no risks.. so it’s a good choice for young pts without comorbidities rather than taking medication life long which has its own complications Hope my answer helps you.. good luck