A study published this month in the journal Archives of Surgery finds that two rarely-used nonsurgical treatments can help people with the symptoms of acid reflux disease, including heartburn. The treatments could help alleviate symptoms in patients who are not helped by acid-reducing drugs.

Gastroesophageal reflux disease or GERD is a relatively common chronic condition in which the contents of the stomach, including the corrosive stomach acid, seep up into the esophagus, irritating its lining and causing inflammation. This usually causes severe, persistent heartburn and it may also cause difficulty swallowing, voice hoarseness, and chronic coughing.

The study examined the use of two “endoluminal therapies” that do not involve incisions but instead use an endoscope, a long flexible instrument inserted through the mouth and down the esophagus. The first, known as full-thickness plication, involves using an endoscope to tighten the junction between the esophagus and the stomach with sutures. The other procedure, called radiofrequency therapy, delivers energy waves to the muscles of the esophagus and stomach to improve the function of the valve between the two organs. 

In the study, the researchers treated 126 GERD patients using one of the two nonsurgical techniques between 2002 and 2006. A total of 58 underwent full-thickness plication and 68 patients underwent radiofrequency treatment. After six months, among the patients who underwent full-thickness plication, the percentage of patients with moderate to severe heartburn decreased from 53 percent to 43 percent and many patients saw improvements in voice symptoms and swallowing difficulties. Among the group receiving radiofrequency treatment, moderate to severe heartburn decreased from 55 percent to 22 percent and decreases were also seen for swallowing difficulties, voice symptoms, and cough. Both groups reported using less much less medication after the treatments.

The most common treatments for GERD are a class of acid blocking medications called proton pump inhibitors. While effective for some, these medications do not work for everyone and they can be expensive. GERD returns in more than 80 percent of cases after people stop taking these medications.

Surgical options have been available since the 1990s, but these are seen as a treatment of last resort due to their invasiveness, cost, and questionable effectiveness. The most commonly used surgery, laparoscopic fundoplication, involves wrapping the top portion of the stomach around the base of the esophagus to strengthen the junction between the two organs.

The two nonsurgical treatments have been available for more than ten years but are still uncommon in part because health insurance companies typically do not pay for them.

If you have GERD symptoms that are not helped by medication or if you have “breakthrough” symptoms several times a week, you may want to talk to your healthcare provider about the nonsurgical options. If you want a more specialized medical opinion, the American College of Gastroenterology has a physician locator to help you find a GI specialist in your area.

For more information about treating GERD, join the conversation at the Healia Health Community for Acid Reflux.

_{Photo: tomsaint11, Flickr, Creative Commons}

Do you experience heartburn twice a week or more? This Thanksgiving week, November 23 – 29, 2008, marks the 10^th annual Gastroesophageal Reflux Disease (GERD) Awareness Week, an effort to raise awareness about this common condition that causes chronic heartburn. GERD affects an estimated 5% to 7% of the global population and as many as 10% of Americans at any one time.

GERD occurs when acid from the stomach seeps up (refluxes) into the esophagus causing pain and leading to tissue damage. There is no single cause of GERD, but the disease occurs more frequently in smokers and people who are overweight or obese.

It is no coincidence that GERD Awareness Week takes place during the week of the Thanksgiving holiday. Family gatherings are often an occasion to overeat, which can lead to heartburn by causing the stomach to secrete large amounts of stomach acid. If you only experience heartburn at annual family gatherings, you probably do not have GERD. However, if you have heartburn again later in the week, perhaps after eating leftover turkey, it may be a good idea to talk to your doctor about GERD.

The most frequently reported symptoms of GERD are heartburn that recurs several times a week and acid regurgitation (often described as a bad taste in the mouth or the back of the throat), but the disease can also cause other symptoms such as morning hoarseness, bad breath, and chronic sore throat. Most cases of GERD can be treated effectively through lifestyle changes and the use of daily medications.

However, if GERD is not treated properly, over time serious complications can occur. Acid eating away at the lining of the esophagus can cause inflammation (called esophagitis) which can lead to erosions in the lining of the esophagus, bleeding, and narrowing of the esophagus tube that make it difficult to swallow and may even cause breathing problems. A small subset of patients with GERD develop Barrett's esophagus, a precancerous condition of the esophageal lining that is a risk factor for a type of cancer called esophageal adenocarcinoma.

Many people with symptoms of GERD do not seek treatment because they think their symptoms are normal. To combat this fact, the International Foundation for Functional Gastrointestinal Disorders (IFFGD) designated GERD Awareness Week in November 1999 to raise awareness about the symptoms of the disease and the possible complications.

Throughout this week, the urges people who experience symptoms of GERD are urged to call the IFFGD heartburn helpline or see a physician as soon as possible. There are many treatment options that can help people with GERD get relief from their symptoms and reduce the likelihood that complications will develop.

To receive information and support regarding GERD call the IFFGD Heartburn Helpline at 1-888-964-2001. For more information about GERD and the chance to connect with others who have the disease, join in the conversation at the Healia Health Community for GERD.

_{Photo: VirtualErn, Flickr, Crative Commons}