Less Invasive Procedures Prove Helpful for GERD Sufferers

Gastro-esophageal reflux disease (GERD) sufferers must take medication on a regular basis to ward off the irritating condition, and while surgical procedures have proven effective, some sufferers would rather have an option that was less invasive. There is new evidence to show that several non-surgical procedures could prove to be very successful in relieving GERD symptoms.

GERD is a condition where someone’s stomach contents backflows into their esophagus. Many times causing irritation and inflation, along with a feeling of heartburn. Doctors now have a couple of options to treat GERD that do not require a surgical incision. The traditional option to medication is laparoscopic fundoplication surgery, a procedure where doctors wrap the top of the stomach around the lower part of the esophagus, creating a barrier for their stomach contents backing up. The Society of Thoracic Surgeons offers suggestions that may help to reduce GERD symptoms, such as losing weight, wearing loose clothing, eating meals several hours before bedtime to allow the stomach to empty, elevating the head of your bed six to eight inches higher than the foot of the bed, and avoid smoking, high-fat foods, chocolate, peppermint, spicy foods, and caffeine.

A newly released study published in the journal Archives of Surgery, found that two endoscopic therapies, procedures that are less invasive than surgery, actually helped to relieve GERD symptoms and reduced the need for antireflux medication, according to the researchers. One of the procedures—full-thickness placation—involves using a long narrow tool that is inserted through the body’s natural entries to tighten the joining of the esophagus and the stomach, by inserting sutures. The other, radiofrequency therapy, is thought to improve the function of the valve connecting the esophagus and the stomach. The new study performed by Dr. Louis O. Jeansonne IV, M.D., with the Emory University School of Medicine in Atlanta and colleagues evaluated the effectiveness of the two therapies. The study considered patients records and medical conditions from 2002-2006, even though full-thickness placation was not available until 2004. Once there were two treatment choices, the decisions were based on the patient’s preference, along with anatomical factors and the surgeon’s opinion. Of the 126 patients evaluated, 58 underwent full-thickness placation and 68 took on radiofrequency treatments.

All patients being evaluated were asked before and after their procedures, to explain their medication use and rate their severity or lack of GERD symptoms. After the average of six months follow up, patients in both groups reported reduced proton pump inhibitor use and resolved vocal symptoms. The group who had radio frequency therapy seemed to benefit from more effective treatment relieving moderate to severe heart burn symptoms from GERD, while full-thickness plication resulted in a substantial decrease in moderate to severe regurgitation scores. Full-thickness placation did not seem to relieve any symptoms for moderate to severe cough, but patients receiving radiofrequency treatments did see benefits.

"Our experience indicates that radiofrequency and full-thickness placation are both effective, providing symptomatic relief and reduction in proton pump inhibitor use. For patients whose chief complaint is regurgitation, full-thickness plication may be the preferred procedure. Further study is needed to determine the long-term effectiveness of endoluminal treatments," said the study authors. According to Dr. Jon Gould, M.D., of the surgery department at the University of Wisconsin Medical School, "Both procedures resulted in GERD symptom improvement and demonstrated an excellent safety profile," but they can’t say what the long-term results may be due to the short duration of follow-up, there will need to be further research.

Hajek, Heather. "Less Invasive Procedures Prove Helpful for GERD Sufferers." 20 Feb. 2009.

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