For patients with gastroesophageal reflux disease (GERD) who don’t want to take medications and don’t want surgery, endoscopic treatment may be the solution.
Dr. Yepuri is one of a few doctors in DFW who can perform endoscopic procedures to treat GERD. He has received specialized mentored training to achieve certification to perform both the TIF and Stretta procedures.
Which Reflux Treatment Is Best for You?
Endoscopic treatments can reduce and even eliminate the symptoms of GERD. Patients need to be evaluated by their doctor to determine which endoscopic procedure is best for them.
What Are Endoscopic Treatments?
Endoscopic treatments don’t require any incisions or hospitalization. These treatments are minimally invasive and pose few risks. This results in a quicker recovery. Doctors perform endoscopic therapies on an outpatient basis.
The Society of American Gastrointestinal and Endoscopic Surgeons recommends two endoscopic treatments for GERD — the TIF and Stretta procedures.
The TIF Procedure
The transoral incisionless fundoplication (TIF) is an endoscopic procedure that treats GERD by reconstructing the muscular valve that connects the esophagus and stomach (lower esophageal sphincter). This procedure is performed under general anesthesia and usually takes less than an hour.
During the TIF procedure, the doctor inserts an endoscopic device down the patient’s throat and into the stomach. The doctor uses this device to fold and fasten the upper part of the stomach around the base of the esophagus. This creates a tight valve that prevents the stomach contents from flowing backward into the esophagus.
The TIF procedure is more effective than medication within the first six months post-procedure and can reduce episodes of acid reflux for several years after. Patients with chronic GERD may benefit from the TIF procedure.
Dr. Yepuri is one of a handful of doctors that performs the TIF procedure in the Dallas-Fort Worth area. He has received specialized mentored training to achieve certification to perform this procedure.
Good Candidates for the TIF Procedure
Good candidates for the TIF procedure include:
- Patients with GERD who are 18 years or older
- Patients who have heartburn or regurgitation after eating
- Patients who want to discontinue medication
- Patients who have a hiatal hernia that is 3cm or less in size
- Patients who don’t want surgery
Before the TIF Procedure
Patients should not eat or drink anything for several hours before the TIF procedure. This is because the stomach needs to be empty to perform the procedure safely.
Patients can take their regular medications the morning of the procedure except for diuretics (water pills), insulin, or other diabetic medications. Patients should stop taking blood thinners before the procedure as instructed by their doctor.
Because the procedure uses sedation, patients need someone to drive them home.
After the TIF Procedure
Patients may experience some temporary discomfort for a day or two after the procedure, such as:
- Sore throat
- Nausea
- Difficulty swallowing
- Hoarseness
Generally, patients can resume their normal daily activities within a few days after the procedure. Patients do need to eat a modified diet, including liquid and soft foods, for a few weeks to allow the new valve to heal properly.
Risks of the TIF Procedure
The TIF procedure is safe for adults. But like any procedure, it has some risks. Risks of the TIF procedure include:
- Bleeding
- Pain
- Adverse reaction to anesthesia
Stretta Procedure
The Stretta procedure is an endoscopic procedure that relieves the symptoms of GERD by using low levels of radiofrequency energy. This procedure is performed under conscious sedation (no general anesthesia) and usually takes less than an hour.
During the Stretta procedure, the doctor inserts a flexible tube down the patient’s throat that delivers radiofrequency energy to the lower esophageal sphincter muscle. The radiofrequency energy thickens and strengthens the muscles of the lower esophageal sphincter. This results in a tighter junction between the esophagus and stomach and reduces random sphincter relaxations. Both of these effects prevent acid reflux.
The Stretta procedure is more effective than medication and can reduce symptoms of GERD for up to ten years. One study found that 86% of patients didn’t need medication to control GERD ten years after the Stretta procedure. Patients with symptoms that aren’t controlled by medication may benefit from this procedure.
Dr. Yepuri is one of a few physicians in the Dallas-Fort Worth area performing the Stretta procedure. He has received specialized mentored training to achieve certification to perform this procedure.
Good Candidates for Stretta Procedure
Good candidates for the Stretta procedure include:
- Patients with GERD who are 18 years of age or older
- Patients who decline laparoscopic fundoplication
- Patients who experience symptoms despite the use of medication
- Patients who want to stop taking medication
- Patients who are poor surgical candidates
- Patients with no or less than a 2cm in size hiatal hernia
Before the Stretta Procedure
Patients should not eat or drink anything for several hours before the Stretta procedure.
Patients can take their regular medications the morning of the procedure except for diuretics (water pills), insulin or other diabetic medications. Patients should stop taking blood thinners before the procedure as instructed by their doctor.
Due to the use of sedation, patients need to arrange for someone to drive them home after the procedure.
After the Stretta Procedure
Patients may experience a sore throat or chest discomfort immediately after the Stretta procedure. However, these symptoms should resolve within a few days. In most cases, pain is manageable with over-the-counter medication.
Usually, patients can resume their normal activities the day after the procedure. Patients may need to eat a soft diet to heal the esophagus properly for the first week.
Risks of the Stretta Procedure
The Stretta procedure is safe for adults. Adverse side effects from this procedure are rare. Potential risks include:
- Bleeding
- Delayed gastric emptying
- Adverse reaction to anesthesia
Minimally Invasive Procedures versus Surgery
Endoscopic procedures provide a minimally invasive treatment option for GERD. These procedures are a safe and effective alternative to surgery.
While surgery can improve symptoms of GERD, it poses more significant risks. Surgery is invasive and requires hospitalization. Potential complications of a surgical fundoplication for GERD include:
- Dysphagia
- Bleeding
- Infection
- Perforation
- Adverse reaction to anesthesia
If you want to learn more about endoscopic treatments for GERD, you can schedule an appointment online or call our office at (817) 267-8470.