Gastroesophageal reflux disease (GERD or reflux) occurs because of a failure of the normal mechanisms that protect the esophagus from the corrosive effects of acid and other stomach juices. Long-standing reflux can cause scarring or bleeding of the lower esophagus. If lifestyle changes such as loss of weight, dietary modifications and sleep position do not produce acceptable relief from reflux, medications such as a Proton Pump Inhibitor (PPI) or an H2 Antagonist are usually prescribed. Although these drugs all reduce acid production in the stomach, there is no effect on the amount of stomach juices that reflux, or on the content of other corrosive components such as bile.
If symptoms require ever increasing doses of drugs, if long-term drug treatment is unacceptable of if complications such as stricture or bleeding have occurred, an anti-reflux procedure could be considered. Over the past 15 years laparoscopic anti-reflux surgery has emerged as the preferable surgical technique for such cases. Hospitalization is usually an overnight stay and return to work can happen in as little as a week.
We are trialling a new endoscopic technique known as the TIF II procedure using the Esophyx device manufactured by EndoGastric Solutions is showing promise as a less invasive way of treating moderately severe long-standing GERD.