Dr. Starpoli blog on GI disorders

GERD - Causes and New Treatments

Written by Anthony A. Starpoli, MD | Mar 1, 2014 4:35:00 PM

Gastroesophageal Reflux Disease, better known as GERD, is a common and painful condition of the esophagus that can potentially affect anyone. This disorder can result in any number of both short and long term very serious consequences for you as a patient including persistent heartburn, regurgitation and increases esophageal cancer risks.. Thankfully, there is a cutting edge treatment called the EsophyX transoral incisionless fundoplication (TIF) that a trained gastrointestinal endoscopist can perform to alleviate issues caused by GERD that may not be controlled by acid lowering medical therapy. The TIF is an incisionless, surgical procedure.

GERD is when the reflux of acids naturally present in the stomach back up into the esophagus. There is a muscle between the esophagus and stomach called the lower esophageal sphincter (LES) that acts as a valve, preventing retrograde movement of stomach contents into the esophagus itself. Very often in GERD sufferers this muscle weakens, allowing for stomach acid to seep into the esophagus. This abrasive acid can damage the lining of the esophagus.

There are many risk factors that can contribute to GERD, including the following:

  • Alcohol, caffeine, and tobacco use
  • Obesity
  • Pregnancy
  • Spicy, fried, and acidic foods

The EsophyX TIF procedure remodels the valve at the conjunction of the stomach and the esophagus and enhances the antireflux barrier.  Medications can be effective, but often require life long therapy and do not address the mechanical issues behind reflux.

Formal surgical procedures, sich as the laparoscopic Nissen Fundoplication involve incisions and longer recovery times.  An EsophyX TIF can generally be completed in under an hour, with success rates of approximately 80-85%, and carries less side effects when compared to traditional surgical antireflux procedures. The side effects avoided with TIF include gas-belch-bloat syndrome, swallowing trouble, and the development of diarrhea. TIF can also be combined with a surgical hiatal hernia repair known as a CTIF (combined TIF and hiatal hernia repair.