Surgery-Free Treatments for GERD

Ivanhoe Newswire Thursday, Jan. 22, 2009

(Ivanhoe Newswire) — Two non-surgical treatments may bring relief to patients with gastroesophageal reflux disease (GERD).

The painful condition is caused when stomach acid backs up into the esophagus. Available treatments range from costly long-term drug therapies to surgery. But recently, endoluminal therapies — entering through natural passages in the body to repair the underlying causes of GERD — have become available.

The first is full-thickness plication, a process that tightens the junction between the esophagus and the stomach with sutures using a long, narrow endoscope. The second is a radiofrequency therapy that delivers energy waves to the muscles of the esophagus and stomach, improving the function of the valve between the two.

Six-month follow-up data revealed that among patients who underwent radiofrequency treatment, reports of moderate to severe heartburn decreased from 55 percent to 22 percent. Decreases were also seen in medication use, swallowing difficulties, voice symptoms and cough. Among full-thickness plication patients, reports of moderate to severe heartburn decreased from 95 percent to 43 percent, with additional decreases in regurgitation, voice symptoms and swallowing difficulties.

“Our experience indicates that radiofrequency and full-thickness plication are both effective, providing symptomatic relief and reduction in proton pump inhibitor use,” the authors wrote. “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.”

SOURCE: Archives of Surgery, 2009;144:19-24

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