What is the TIF for heartburn and does it work?
As the director of Clinical Research for the Minimally Invasive Surgeons of Texas at the University of Texas Health Science Center in Houston, I participate in many research studies. I recently participated in and finished a study using the Esphophyx device to perform Transoral Incisionless Fundoplication (TIF). This is a device that goes down the mouth to strength the valve between the esophagus and the stomach to reduce heartburn and regurgitation (reflux) symptoms that many people suffer from despite taking medications that block acid production. This procedure, which takes about an hour to perform, is done completely through the mouth, so there are no incisions on the abdomen. It works by placing a fastener across the tissue of the stomach and the esophagus to create a strong barrier to reflux.The results of the study are promising. This study was done at several institutions throughout the United States and performed by many experienced TIF surgeons and gastroenterologist. Although the study was not the most powerful study, it did have well defined criteria for enrollment and had a large sample size of 100 patients.
The study’s principle evaluation was the long-term effects of the TIF. We looked at several questionnaires to tell us how patients felt the operation worked as well as some test to evaluate the effectiveness of the procedure. Throughout the year, the patients who underwent the procedure in the study were re-evaluated and nearly all of them followed-up.All of the patients had long standing heartburn symptoms (about 9 years), and there were no major adverse events or complications in any of the patients who had the procedure. This speaks volumes about the safety of the procedure. However, the procedure must be effective too, and it was.
Nearly all the patients had a significant improvement in the Reflux scores on all three different questionnaires we gave them. Only six patients failed to improve and went on to have another operation. 85% of the patients reported that they were well satisfied with their results at a year. Nearly three-quarters of them were completely off their heartburn medication one year after the surgery. The valve that was created remained completely intact over the 12 months study period, there was an 81% reduction in hiatal hernia, and 76% had healing of esophagitis (inflamed esophagus from acid reflux).The side effects from the procedure were minimal. Out of the 94 patients that followed-up, only six of them had any recurrent symptoms like difficulty swallowing, bloating, or increased flatulence. These are very small numbers compared to other surgical treatments for reflux (e.g. Nissen).
In conclusion, the TIF is an incisionless surgical alternative to medication for the treatment of heartburn and reflux symptoms. It has proved to be a very safe and durable procedure, at least out to 12 months, with very little adverse side effects. It is important that the surgeons or gastrointestinal doctors performing these operations select patients carefully. Not everyone should have this operation to treat their reflux. Morbid obesity, large diaphragm hernias, and severe reflux disease are indications for treatment other than TIF. The results a patient obtains from the TIF is highly dependent on the experience of the doctor performing it.
If you suffer from chronic heartburn or reflux disease, taking medications on a daily basis, and want to get off those medications, the TIF may be a possible treatment for you. Most people suffering from this disease can be treated. Make a consultation today to find out!
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