Dr. Starpoli's Blog

Incisionless Anti-reflux Therapy: a chance to stop your reflux drugs.

Posted by Anthony A. Starpoli, MD on Jun 5, 2019 10:54:02 AM

Gastroesophageal Reflux Disease (GERD) is a life-affecting condition that affects as many as 20% of the population. Given the prevalence of GERD, the quest for suitable treatment methods has been a relentless one— but often to little effect.

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Anthony A. Starpoli, MD | www.starpoli.com

Obesity, Reflux, fundoplication, atypical reflux, heartburn, EsophyX, incisionless surgery, GERD Awareness Week

Silent Acid Reflux

Posted by Rachel Jones on Feb 20, 2014 9:44:00 AM

Silent acid reflux, also known as Laryngopharngeal Reflux or LPR, is a condition that you could be suffering from without even knowing it, and can have many negative impacts on health. Similar in many ways to Gastroesophageal Reflux Disease (better known as GERD), there are a few critical differences that can make silent reflux very difficult to treat, and even harder to diagnose. 

As opposed to traditional GERD, silent acid reflux may not present itself with symptoms normally associated with the condition. Normally reflux disease causes a burning sensation in the chest or throat, as well as the stomach. LPR is called silent reflux because often it does not cause these same problems, but can cause a number of other symptoms--including, but not limited to:

  • Chronic couging or hoarseness 
  • Asthma or breathing problems
  • Sleep apnea
  • Constant need to clear the throat
  • Excess mucus build up

Caused by a weakness in the muscles between the esophagus and the stomach, silent reflux can have many negative long and short term implications such as recurring ear infections, ulcers in the stomach and throat, scarring of the throat and voice box, in addition to very serious conditions like emphysema and cancer. 

It takes a very skilled Gastroenterologist to diagnose silent acid reflux--if you suspect you may have the condition, it is important to consult a Physician immediately.

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Anthony A. Starpoli, MD | www.starpoli.com

atypical reflux, nonacid reflux, starpoli, symptoms

EsophyX TIF Procedure is Superior to Maximum Dose PPI Therapy

Posted by Anthony Starpoli on May 30, 2013 12:30:00 AM

As reported by Medscape, according to research presented at the Digestive Disease Week meeting, “patients with gastroesophageal reflux disease (GERD) might benefit more from transoral incisionless fundoplication (TIF) than from continued treatment with proton-pump inhibitors (PPIs).” The study’s lead author Karim Trad, MD, said, “In this study, transoral incisionless fundoplication was superior to maximal-dose PPIs in eliminating daily troublesome typical and atypical symptoms in selected patients.” Dr. Trad added that the findings “establish for the first time that, for some patients, the procedure is better than maximal-dose PPI therapy for controlling a range of GERD symptoms.”

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Anthony A. Starpoli, MD | www.starpoli.com

hiatal hernia, fundoplication, LINX, GERD, atypical reflux, EsophyX, incisionless surgery, esophageal cancer

Refluxology: The Study of GERD

Posted by Anthony Starpoli on Jul 21, 2012 11:36:00 AM

So, you think you have acid reflux?  What is acid reflux?  Why is it called acid reflux?

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Anthony A. Starpoli, MD | www.starpoli.com

Obesity, GERD, atypical reflux, nonacid reflux, heartburn, EsophyX, incisionless surgery, Barrett's Esophagus

New Surgical Therapy for GERD: The LINX Magnetic Bracelet

Posted by Anthony Starpoli on Apr 23, 2012 9:27:00 AM

A new laparoscopic therapy for reflux has been recently approved for the treat of reflux.  The procedure requires laparoscopic surgery (small incisions in the abdomen) in order to place this new device at the level of the lower esophageal sphincter.  Certain limitations will occur as the result of this procedure as will be discussed.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, hiatal hernia, TIF, LINX, GERD, atypical reflux, heartburn, EsophyX, Barrett's Esophagus

FDA Warns: Reflux Drug Therapy & Increased C. difficle Diarrhea

Posted by Anthony Starpoli on Mar 13, 2012 2:51:00 AM

Several news agencies recently reported concerns of the FDA over the increased risk of Clostridium difficle diarrheal illness in patients using acid lowering antireflux drugs in the treatment of gastroesophageal reflux disease (GERD).

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Anthony A. Starpoli, MD | www.starpoli.com

c. difficile, hiatal hernia, GERD, atypical reflux, EsophyX

Dental Detriments of GERD

Posted by Anthony Starpoli on Mar 13, 2012 2:35:00 AM

A six-month follow up of 12 people with GERD and six others who were not suffering from the condition showed that those with acid reflux had much worse tooth wear and erosion. 

Tooth erosion may naturally occur due to chewing but about half of GERD patients had tooth wear and erosion several times higher than the healthy counterparts, says the report inJournal of the American Dental Association

The acid from the stomach is strong enough “to dissolve the tooth surface directly, or soften the tooth surface, which is later worn down layer by layer,” said lead author Dr. Daranee Tantbirojn of the University of Tennessee. 

“The damage from acid reflux looks like tooth wear -- the tooth is flattened, thin, sharp or has a crater or cupping.” 

Saliva acts as a defense mechanism because its buffering capacity helps protecting teeth in neutralizing acid, but it cannot fully protect teeth against all acid condition in mouth formed after eating and drinking or due to acid reflux from stomach. 

Researchers suggested people with acid reflux to follow some measures to lower their teeth damage. They, for instance, should avoid brushing their teeth immediately after an acid reflux episode and use a fluoride rinse instead. 

Using Xylitol chewing gum and taking baking soda or antacids after acid reflux episodes can also protect teeth against erosion. 

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, GERD, atypical reflux, nonacid reflux

Hybrid GERD Surgery Performed at NYU Langone Medical Center

Posted by Anthony Starpoli on Oct 14, 2011 11:40:00 AM

On September 7th and October 13th, 2011, the first two combined laparoscopic and transoral antireflux procedures were performed at the New York Univerisity Langone Medical Center in New York City.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, hiatal hernia, TIF, fundoplication, GERD, LPR, atypical reflux, heartburn, EsophyX, Barrett's Esophagus

Doctor Radio-SIRIUSXM and NYU Features Dr. Starpoli and TIF

Posted by Anthony Starpoli on Jun 21, 2011 7:47:00 AM


Today Dr. Starpoli will be hosted on the Doctor Radio show to discuss GERD and transoral incisionless fundoplication with EsophyX.  This procedure serves as an alternative to chronic, long-term drug therapy that millions of people world-wide must take to control their reflux.  Given new information on the perils of long-term drug therapy for reflux, antireflux surgery is being more considered every day.

Doctor Radio is a groundbreaking 24/7 national radio channel featuring live,

call-in shows hosted by leading NYU Langone Medical Center doctors from a vast

array of fields including: child psychology and psychiatry; sexual health;

plastic surgery; emergency room medicine; cancer; heart health; women's health;

dermatology; pediatrics; men's health; diet and nutrition; sports medicine;

psychiatry; and more.


SIRIUSXM and NYU have built a state-of-the-art broadcasting studio

in the lobby of the Manhattan-based NYU Langone Medical Center, bringing

listeners right into the middle of the medical world.

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Anthony A. Starpoli, MD | www.starpoli.com

TIF, doctor radio, GERD, atypical reflux, heartburn, EsophyX, Barrett's Esophagus

Does GERD increase with age?

Posted by Anthony Starpoli on Jan 3, 2011 8:46:00 AM

As reported in MedWire (12/31, Albert) reported that after reviewing 16 studies, UK researchers concluded "that the prevalence of gastroesophageal reflux disease (GERD) does not increase with age, but that esophageal symptoms of sufferers become more severe as they get older." According to the paper in Alimentary Pharmacology and Therapeutics, the "largest of these studies (n=11,945) showed that the prevalence of severe reflux esophagitis increased significantly with age from 12% in those younger than 21 years to 37% in those aged 70 years or above," but "heartburn was less common in older than younger GERD patients." Investigators also pointed out that "esophageal 24-hour acid exposure time increased by 1.1% for each additional decade in age," while "ineffective esophageal motility increased and abdominal lower esophageal sphincter length decreased with age."

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Anthony A. Starpoli, MD | www.starpoli.com

GERD, atypical reflux, EsophyX