Help for those with chronic heartburn

For those afflicted with the misery that chronic heartburn brings, and tens of millions of Americans suffer from daily reflux, with symptoms that range from burning in the chest (heartburn) to regurgitation, chronic cough and hoarseness, there is relief available in the form of an incision-free surgical solution.

The option available is a procedure called Transoral Incisionless Fundoplication, or TIF, that uses a device called EsophX that lets the surgeon perform a surgical procedure without any incisions. This procedure is now available at Trinity Health and Dr. Gary Wease, a board certified general surgeon at Trinity, has brought this innovative approach to treating Gastroesophageal Reflux Disease.

The procedure has been done in the U.S. for eight years, but Wease said he is the only person within a 200-mile radius who is doing it.

“The main cause of reflux or heartburn is an anatomical abnormality at the junction where the esophagus connects to the stomach,” Wease explained. “When a person swallows, the valve between the esophagus and the stomach opens to allow food to pass and then closes again to prevent stomach fluids from backing up into the esophagus. For people with chronic acid reflux, this valve has become dysfunctional.”

Typical treatments usually involve medications that reduce the production of gastric acid, Wease said. The problem with medical therapy, though, is that it’s designed for short-term use, he added.

“I meet people in my office who have been on medication for 15 to 20 years because they never sought another alternative,” he said.

Until recently, surgical alternatives have ranged from open surgery to a laparoscopic procedure performed through small incisions. With Transoral Incisionless Fundoplication, though, there is a much better option.

“The TIF procedure is done entirely through the mouth with no incision,” Wease said. It involves taking the upper part of the stomach and wrapping it around the esophagus to recreate tissue valve, he added.

The TIF procedure is performed under general anesthesia and generally takes an hour or so. The EsophX device and an endoscope are introduced through the patient’s mouth and advanced into the esophagus. Using visualization provided by the endoscope, the surgeon uses the EsophX device to reconstruct the anti-reflux valve by wrapping the stomach’s fundus around the distal esophagus and securing it with fasteners. Recovery is typically three to seven days. Wease said the procedure is typically done on a Friday and the patient typically returns to work on Monday. The procedure is permanent once it’s done, he added.

The main benefit to having this procedure done is for the patient to be off medications for chronic heartburn, Wease said. All of the medications have the side effect of osteoporosis, he added, and if those are taken with certain heart medications, the heart medications can be rendered inactive.

“Eighty-five percent of patients are completely off medications within two weeks after the procedure and are symptom-free after three years,” Wease said. Additionally, the complication rate is almost unheard of with this procedure, since there is only one way to do it and each physician is trained the same way, he added.

Some people are not candidates for the TIF procedure, though, Wease noted, like obese people or children. People need to have a series of tests done to make sure they’re candidates for the procedure and will benefit from it, he added.

While the TIF procedure is a new addition to Trinity Health, Wease has experience performing it while at his previous hospital in Michigan. Patients who have had the procedure done have been extremely satisfied, Wease said. Most of the complaints are from people not following post-procedure instructions, he added. “People have to follow a diet plan for a month after the procedure and then they can eat what they want after that. Most people comply with the diet, though.”

Wease said he wants people to know that this procedure is now available at Trinity Health and that it works. “Recovery is short, pain is minimal, and the results are the equivalent to the Gold Standard surgical procedure,” he said.

“What I tell patients is that with TIF we can’t say that it will 100 percent eliminate one’s chances of having heartburn again, but it can significantly improve your quality of life. Wherever you sit on the scale of discomfort, this can enable you to be 85 percent better.”

For more information or to make an appointment, Wease can be reached at 857-5764.