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Question: What is
gastroesophageal reflux, or acid reflux, disease?
Answer: Gastroesophageal reflux disease is a condition in which the contents of the stomach will reflux out of the stomach into the esophagus. Although most individuals will experience some occasional episodes of reflux, it is considered gastroesophageal reflux disease (GERD) when the reflux occurs on a frequent and recurring basis.
Q: How and why do people get this disease?
A: Reflux is most commonly caused by a weakened valve at the lower esophagus called the lower esophageal sphincter. Other causes may be related to abnormalities of how the esophagus moves or delayed gastric emptying. Obesity is a common cause of reflux symptoms. Other causes include caffeine and red wine, and some medications will reduce the pressure of the lower esophageal sphincter resulting in reflux.
Q: What are the symptoms of reflux?
A: Common symptoms include heartburn, regurgitation, chest pain and a bitter taste in the back of the throat. Many patients are not able to lie down without having reflux or regurgitation. Difficulty swallowing may be seen in patients that develop either a stricture or narrowing of their esophagus from reflux or those that have developed a hiatal hernia.
Q: Could the pain I'm feeling be something other than reflux?
A: Symptoms of reflux may be confused with other conditions such as heart disease, gallbladder disease and other gastrointestinal disorders.
Q: Are there ways to prevent this disease? Are there ways to control or cure the problem? Is there a risk of cancer associated with reflux?
A: Reflux can be treated by lifestyle modifications including weight loss, smoking cessation, alcohol avoidance and avoiding eating meals late in the day. Elevating the head of your bed on a couple of blocks may help nocturnal symptoms. When symptoms are not controlled with these lifestyle modifications, acid suppressing medications can be utilized. The most common medications are proton pump inhibitors such as Prilosec, Nexium and Protonix.
Anti-reflux surgery should be considered in some patients, including those who require lifelong medical therapy for reflux. It also might be needed for patients who have persistent symptoms in spite of medications or those that have developed complications from their reflux such as strictures, esophageal ulcers, and large hiatal hernias. Anti-reflux surgery has the advantage of "curing" reflux as the surgery will recreate the lower esophageal sphincter and prevent acid from leaving the stomach. The most common anti-reflux surgery is called a Nissen fundoplication. This surgery may be performed utilizing minimally invasive techniques. Postoperative pain is minimal and the procedure can be an outpatient one. Patients will have resolution of their reflux symptoms immediately following the procedure as the new valve begins to work immediately.
Dr. J. Scott Roth is chief of gastrointestinal surgery and director of minimally invasive surgery at the UK Medical Center and assistant professor of surgery in the UK College of Medicine.

New procedure could "block the burn" of acid reflux, Dawndy Mercer Plank reports

COLUMBIA, SC (WIS) - Regurgitation, a sore throat and frequent swallowing are just some of the symptoms of acid reflux disease. Add to that the most common, heartburn and chest pain, and you're desperate for relief. But one procedure that may be just what the doctor ordered.

One doctor visit could change Pamela Feuerstein's life. She has a significant case of acid reflux.

"It's a burning in your chest," said Feuerstein. "Usually, it's right here and I have a fullness that will not go away. And usually if it lasts more than thirty minutes to an hour, I get significant nausea."

Doctors say if you have heartburn twice a week or more you probably have acid reflux, also known as gastroesophageal reflux disease or GERD. Avoiding reflux means having to avoid certain foods.

"My favorite food is pizza, and I just cannot tolerate it anymore," commented Feuerstein. "I can't tolerate any alcohol, like going out socially."

Dr. Marc Antonetti of riverside surgical group at Lexington medical center says no one is immune to reflux problems.

"Reflux can happen from infants all the way up to senior citizens," said Antonetti. "It most commonly happens as people begin to age, as people get over the age of forty, the symptoms worsen."

Pamela knows how to treat the symptoms -- she's a pharmacist.

"I take prescription medication," said Feuerstein. "I also take over-the-counter as needed. And sometimes, it works. If I have a really bad flare-up, nothing makes it go away. I just have to work through it."

But nothing was working, so she's undergoing a new, cutting-edge, incisionless surgery that should get rid of the problem for good. It's called EsophyX TIF.

"This whole idea of incisionless surgery, this is really the next, great leap forward in surgical technology," said Antonetti.

Dr. Antonetti inserts a tool through the patient's mouth to repair the weakened valve so it will close properly, keeping the stomach contents from moving up.

"We pull the stomach back down into the abdomen and we tighten up that valve by placing sutures that basically wrap the top of the stomach around the esophagus," said Antonetti.

No incisions, no scarring and a fast recovery. But did it work?

"It was for me, because I suffered with it every singe day," said Feuerstein. "I took medication, prescription medication and it had gotten to where that wasn't working and it worsened and I would have to add medication and I was still miserable, so it has been worth it."

Recent studies on EsophyX TIF report 80 percent improvement in quality of life and reduction or elimination of heartburn symptoms.

"I feel great," said Feuerstein. "It's made a huge difference. I'm glad I did it."

Most patients go home the next day after EsophyX TIF and return to normal activities within a few days. Most insurance plans do cover this new procedure.


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