Non-Surgical Treatment Offers Relief from Acid Reflux

Dr. Jon Gould, UW Health surgeon

MADISON -The condition's name is a mouthful - gastroesophageal reflux disease, or GERD. Its sufferers know it better as acid reflux, and they certainly know its symptoms: a burning or tightness in the chest and often the taste of acidic bile in the mouth.

 

For some, lifestyle changes (no spicy foods after 6pm) and over-the-counter or prescription medications (antacids and acid reduction pills) can effectively control GERD symptoms.

 

But patients whose reflux symptoms continue to be a bother despite medicines and other measures don't necessarily have to resort to surgery to get relief. Instead, they can turn to a little-known procedure with a name that's also a mouthful - transoral incisionless fundoplication, or TIF.

 

Unlike the Nissen fundoplication, a more common treatment for reflux, TIF isn't an abdominal surgery, explains Jon Gould, MD, a minimally invasive surgeon at UW Hospital and Clinics in Madison who treats patients with GERD. No knives or scalpels are involved.

 

"The fact that there are so many pharmaceutical companies offering pills to treat this condition speaks to how prevalent it's become. There's a lot of interest in coming up with a solution that doesn't come down to the difference between taking a pill and all-out abdominal surgery," explains Dr. Gould. "But there aren't many patients who suffer from GERD symptoms who also know that TIF could be a possible option for them."

 

Acid reflux is the number one gastrointestinal condition for which people seek medical help. Dr. Gould estimates that as many as 10 percent of Americans battle daily heartburn or acid reflux.

 

TIF involves inserting a device through the patient's mouth and down into the esophagus, where Dr. Gould uses it to form and fasten tissue folds in a 240-degree swoop, creating a valve at the junction between the esophagus and the stomach that can prevent stomach acid from refluxing. General anesthesia is used, and the patient is often monitored overnight. Because no scalpels are used, there's no scarring.

 

"For those who have the perception that a Nissen fundoplication has side effects and a high failure rate, this option may be a lot more palatable," says Gould.

 

TIF carries some side effects-minor discomfort, bloating and gas pains are the most common-but has proven quite effective at relieving GERD symptoms in preliminary studies. Not every patient with GERD, however, is a candidate. According to Dr. Gould, ideal candidates are patients with moderate GERD symptoms and who are on medical therapy, but who don't feel that their symptoms are significant enough to warrant surgery.

Date Published: 01/28/2010