Transoral Incisionless Fundoplication (TIF)

What is Acid Reflux (GERD)

Acid reflux is one of the most common diseases in America.  It is the feeling of burning in the chest, pain in the chest or stomach especially after eating. 1 in 4 Americans now suffers with heartburn. It is caused by acid from the stomach refluxing into the esophagus (food pipe).

How do you treat GERD?

Heartburn and GERD is generally managed with weight loss, smoking cessation and diet.  For those patients that do not respond to these conservative interventions, antacid medications may be needed to manage symptoms.  There are many antacid medications available now both by prescription and over the counter.  Sometimes whole aisles of drug stores can be filled with various forms of antacid medications.  However up to 50% of patients will not respond to medications. Also some people would not prefer to take antacid medications for a variety of reasons including possible side effects.

For those patients an anti-reflux procedure may be their best therapeutic option. The goal of anti-reflux procedures is to tighten the connection between the esophagus and stomach to prevent acid from refluxing. This has conventionally been a surgical procedure for many years. However now endoscopists can tighten the esophago-gastric junction completely endoscopically without any incisions.

What is Transoral Incisionless Fundoplication (TIF)?

Transoral incisionless fundoplication (TIF) is a novel, completely endoscopic procedure that allows endoscopists to tighten the connection between the esophagus and stomach.  By doing this less acid can reflux back from the stomach into the esophagus and potentially cure GERD symptoms.  TIF is a minimally invasive alternative to the traditional anti-reflux surgery and has been shown to be effective in well-designed clinical trials.  High quality studies have also shown the TIF procedure to work better than some of the best antacid medications (PPIs). TIF has been shown to be safe and can be performed even on an outpatient basis.

What are the benefits of TIF?

With the TIF procedure, patients don’t need to worry about scars because the entire procedure is performed from inside the body.  Because of the minimally invasive technique, patients have a quick recovery.  Often patients can be back to work in a few days.  Aside from these benefits, TIF has been shown to be safe and effective.

Who is a candidate for TIF?

The most appropriate candidate for the TIF procedure is an individual who has regular symptoms of GERD, who is not responding to medical or conservative therapy, or someone who just does not want to take antacid medications anymore.  Not all patients with GERD however can be TIF candidates.  Only those patients that have a small or no hiatal hernia (upward slipping of the stomach above the diaphragm) are candidates for the TIF procedure.  Thus a diagnostic EGD (Hyperlink) may be necessary to determine anatomic candidacy.  Those patients with a large hiatal hernia may be best suited for surgical options to treat the hernia at the same time.

What can I expect during and after the procedure?

The TIF is performed under general anesthesia, thus the patient will not remember or feel any pain.  The procedure involves passing an endoscope through the mouth to the level of the connection between the stomach and esophagus.  Specialized instruments on the endoscope allow for reconstruction of the antireflux valve to prevent future GERD symptoms.  The procedure generally takes less than 1 hour to complete

After the procedure is complete patients may either go home the same day vs. the next day depending on how they feel.  Patients may feel a sore throat, stomach and shoulder after the procedure for a few days.  Patients are also placed a special diet for weeks after the procedure to allow for proper healing of the new valve.  Most patients are also able to go back to work and typical duties in a few days.  Antacid medications are weaned off completely usually a few weeks after the procedure.

Transoral Incisionless Fundoplication (TIF) in Dallas

Are you interested in learning more about TIF or GERD, or other treatment options? We invite you to contact us to learn more. Dr. Prashant Kedia is a therapeutic endoscopist and gastroenterologist serving patients in the Dallas-Fort Worth area and beyond. Call today to schedule an appointment at (214) 941-6891.

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