Gastroesophogeal Reflux Disease (GERD)
URMC Offers New Implantable Heartburn “Ring”
The University of Rochester Medical Center (URMC) is one of the initial U.S. surgery sites chosen to offer the new LINX™ Reflux Management System by Torax Medical Inc. This innovative implantable magnetic “ring,” which was awarded FDA-approval in March 2012, promises relief to the estimated 25 million American adults who suffer from daily heartburn or gastroesophogeal reflux disease (GERD).
Learn even more about the LINX Reflux Management System in this expanded interview with URMC esophageal surgeon Jeffrey H. Peters, M.D.
What Is GERD?
GERD is a condition where the stomach’s acidic juices backflow into the esophagus, rousing an uncomfortable burning sensation just below the breastbone. Though a muscular ring, or sphincter, usually tightens to clamp off this backsplash, this natural “barrier” is faulty in some people. The normal barrier to reflux is weak or the sphincter relaxes to easily, causing food or liquid in the stomach to flow back into the esophagus. This can irritate the esophagus, resulting in heartburn and other symptoms.
“While GERD is rarely life-threatening, its pain can derail patients’ daily routines, and in select cases, frequent reflux can cause serious damage to the skin-like surface of the esophagus – a condition called Barrett’s esophagus, which carries a small risk for esophageal cancer. As the incidence of GERD rises – possibly tied to the mounting international obesity epidemic – efforts to manage the condition have become increasingly important.”
Jeffrey H. Peters, MD
Seymour I. Schwartz Professor
and Chair of the URMC
Department of Surgery
What Are the Treatment Options for GERD?
Patients with GERD are first advised to make dietary and lifestyle changes such as losing weight, eating smaller meals and avoiding certain types of foods that may trigger symptoms.
There are also over-the-counter and prescription medications available, including antacids, proton pump inhibitors (Omeprazole) and H2 blockers (Ranitidine), for those who do not respond to dietary and lifestyle measures.
Surgical treatment is usually reserved for people who have residual symptoms of chronic GERD or a large hiatal hernia, a condition in which part of the stomach pushes upward through the diaphragm. Surgery is also an option for individuals who cannot follow their recommended treatment or who want to avoid a lifetime of medical therapy.
Surgical Options for GERD Include:
Nissen Fundoplication – Most often done laparoscopically, this common procedure for GERD typically takes 60 to 90 minutes to perform and requires a one-night hospital stay. Most patients are able to return to work in two to four weeks. Following surgery, 90 to 95% of patients have good control of typical GERD symptoms.
Endolumenal Procedures – These procedures are performed through the mouth and without any abdominal incisions. Esophyx TIF and Stretta are the only endolumenal surgical options currently available in the U.S. These procedures usually take 45 to 60 minutes and require a one-night hospital stay. Most patients are able to return to work in one to two weeks. Following surgery, 60 to 80% of patients have good control of typical GERD symptoms, however, these procedures are not recommended for individuals with a moderate to large hiatal hernia or Barrett’s esophagus.
LINX™ Reflux Management System – Only available at select centers, including URMC, this new procedure is performed on an outpatient basis. It takes about 30 to 45 minutes to implant the magnetic “ring” around the lower end of the esophagus. Most patients are able to return to work in one to two weeks. LINX is not an option for individuals with more than a 3cm hiatal hernia or Barrett’s esophagus.