The condition can be serious. Prolonged acid reflux even can result in chronic inflammation of the esophagus and a change in its lining, known as Barrett’s esophagus. This condition can contribute to cancer of the esophagus.
GERD results when stomach acid or intestinal bile backs up from the stomach into the esophagus, the tube connecting the mouth with the stomach. Normally the antireflux barrier valve between the esophagus and stomach closes after allowing food to pass. However, when this valve fails to close completely, stomach acid or intestinal bile can reflux out of the stomach.
Common causes of the deterioration of the valve include excessive weight, diet, aging and injuries to the stomach.
The most common treatment options are diet and lifestyle changes as well as pharmaceuticals. While these treatments can alleviate the symptoms, they don’t solve the underlying anatomical problem and disease progression.
Over time medications might require increased dosage as they become less effective. This not only increases their cost; these medications can lead to inadequate absorption of minerals such as calcium, and the lack of calcium can result in bone fractures. Even with medications, many patients still cannot eat the foods they want and some even need to sleep sitting up to reduce nighttime reflux.
In moderate to severe GERD, surgery can be an option. Surgeons have used invasive procedures such as the Nissen fundoplication to provide an effective therapy for acid reflux. However, even when the Nissen fundoplication is performed using laparoscopy, the risk of adverse events and the invasive nature of this and similar procedures have made them lose popularity in recent years.
Patients can now benefit from a new surgical procedure that offers relief from acid reflux without surgical incisions. This new procedure is known as transoral incisionless fundoplication (TIF), and it is now available to the community for the first time at Northern Nevada Medical Center.
TIF requires neither internal incisions nor dissection, allowing for a less invasive anatomical restoration of the antireflux barrier. The new technique is described as “surgery from within.” With the patient under general anesthesia, the surgeon inserts a device through the mouth and lowers it toward the stomach. A camera in the device enables the surgeon to see the operating site.
The surgeon then manipulates the device to make and fasten several tissue folds, known as plications. This creates an antireflux valve at the junction of the stomach and esophagus.
Most patients go home the next day and can return to work and most normal activities within a few days. In the weeks following surgery, a natural healing process fuses and cements the plications to create a durable antireflux barrier. The patient has no visible scarring and less pain than with laparoscopy.
Clinical studies reflect the success of the TIF procedure: After two years, nearly 80 percent of patients no longer need their daily acid reflux medications and have returned to eating foods that they could not tolerate before the surgery.
If you suffer from acid reflux, talk with your physician about this groundbreaking new surgical option, or ask for a surgeon who performs this procedure at 352-5300.
Michael Murray, MD, FACS, is a general surgeon with Northern Nevada Medical Group. Board certified in general, breast and endoscopic surgery, he is located at Vista Medical Terrace at 2345 E. Prater Way, Suite 107. He graduated from Hahnemann School of Medicine in 1988. He completed his residency in general surgery at the Medical College of Pennsylvania and his internship at Allegheny General Hospital in Pittsburgh.