Would an abdominoplasty make GERD worse?

I think that you are wise to be concerned about the gastroesophageal reflux issues and performing a tummy tuck operation. I think that you will be best off seeking consultation with your gastroenterologist and possibly having him/her communicate with your plastic surgeon prior to making any decisions. If you do decide to proceed, best to exercise caution when it comes to the “tightness” of the abdominal wall plication  perform for you.Best wishes.

You have a diastasis. This is definitely correctable by an abdominoplasty. You also have GERD as indicated by your acid reflux. I don't know the exact etiology of your reflux even though you neurologist attributes it to your diastasis. Your concern that an abdominolpasty will exacerbate the problem is realistic. In most abdominoplasty procedures, the muscle wall is plicated. This will make the effective diameter of the muscle wall smaller. This then reduces the intra abdominal volume. All of the organs, including the stomach, have not changed size, but are now squeezed into a smaller cavity. The stomach is squeezed, pressure in the stomach increases. This increases pressure at the stomach-esophageal juncture. This increases the potential for reflux. any time there is abdominal wall plication this potential exists. Imagine doing this when somebody already has acid reflux.