The name of the procedure may be a mouthful, but for people suffering from gastroesophageal reflux disease (GERD) — or acid reflux — it’s a way for them to be able to enjoy eating again, potentially without having to take a pill every day for the rest of their lives.
The procedure is called transoral incisionless fundoplication (TIF), and it’s now offered at Tanner Health in Carrollton.
“Patients with GERD are often stuck between a rock and a hard place,” said Watcoun-Nchinda Pisoh, MD, a board-certified gastroenterologist with West Georgia Gastroenterology and a member of Tanner Health’s medical staff (pictured at top right). “They’re afraid of the possible complications or long-term side effects of surgery. But they also don’t want to keep taking medications like proton pump inhibitors (PPIs), which can come with their own side effects — from malabsorption of vitamins and minerals to possible kidney and heart problems.”
Enter TIF — and a related surgery, cTIF — combining hiatal hernia repair with the TIF procedure. Dr. Pisoh and José E. Espinel, MD, a general surgeon with Carrollton Surgical Group and a member of Tanner Health’s medical staff (pictured at bottom right), recently completed Tanner Health’s first-ever joint cTIF.
“The reason we get reflux is that the gastroesophageal valve — a band of muscle between the esophagus and the stomach — weakens, allowing stomach acid to flow back up,” said Dr. Pisoh. That can cause a secondary issue: The stomach starts to bulge up through the diaphragm, creating a hiatal hernia.
TIF and cTIF are endoscopic options for patients suffering from GERD. Developed about 15 years ago, the TIF procedure uses a special device, allowing gastroenterologists and surgeons to essentially restore the body’s normal gastroesophageal valve. The procedure involves partially and gently folding a small portion of the stomach around the lower esophagus. Recovery time is also short — about a week at most — since both TIF and cTIF are minimally invasive procedures.
Candidates for TIF or cTIF are patients with chronic acid reflux who have been taking PPIs — such as omeprazole, lansoprazole and many others — for six months or longer and who still experience breakthrough symptoms such as heartburn and chronic regurgitation or atypical symptoms like asthma or chronic cough, which medications don’t work well to treat or control.
Allen Hansard, senior program development manager for EndoGastric Solutions, is a former GERD sufferer himself who now works with Tanner Health’s TIF and cTIF program.
“My family called them the hum-hums,” said Hansard, referring to his constant coughing and throat-clearing.
And before his own cTIF surgery, his symptoms were accelerating: If he missed a dose of his medication, he said his symptoms were “horrific,” including severe burning and tightness in his chest. His vocal cords are permanently scarred from reflux.
Only a week after his cTIF procedure, Hansard said, “I was feeling great, I was GERD free.” When he was cleared for solid foods, he ate spaghetti for the first time in more than five years.
“About three months later, I was home in my office having lunch,” said Hansard. “It was a barbecue sandwich and a lemonade, and about halfway through, I stopped and was like, ‘Oh my goodness.’ Not in a million years would I have been able to do that prior to having surgery.”
“Patients are extremely glad to be off medications finally and not subjected to lifetime medication use,” said Dr. Pisoh. “They’re excited to avoid the risks of long-term PPI use. They’re happy with their quality of life now because they no longer have to elevate their bed and they don’t have to avoid their favorite foods and beverages.”
To discuss effective, long-term solutions for GERD, talk to an experienced gastroenterologist. Tanner Health’s 24-hour physician referral line at 770-214-CARE can help, or use Find a Provider to find a gastroenterologist on Tanner’s staff near you.