ALLERGY, RESPIRATORY
Molecule in Skin May Link Eczema and Asthma
Folic Acid Might Offer Allergy Relief
Childhood Food Allergies on the Rise
ALTERNATIVE MEDICINE
Imaging Sheds Light on How Acupuncture Works
Yoga May Bring Calm to Breast Cancer Treatment
Indigo Ointment Benefits Psoriasis Patients
ANIMAL CARE
Beware of Dog Bites
'Comfort Dogs' Come to Emotional Rescue
Separation Anxiety, Canine-Style
BONES & JOINTS
Fractures in Older Adults Up Death Risk
Osteoporosis May Raise Risk for Vertigo
Hip Replacement Boosts Mobility at Any Age
CANCER
Supplement Hampers Thyroid Cancer Treatment
Vitamin E, Selenium and Soy Won't Prevent Prostate Cancer
Family History Key Player in Brain Cancer Risk
CAREGIVING
Children's Bath Products Contain Contaminants
Falls Are Top Cause of Injury, Death Among Elderly
Undoing the 'Big Baby' Trend
CIRCULATORY SYSTEM
Mercury in Fish Linked to High Blood Pressure
Exercise Extends Life of Kidney Patients
Vitamins Do Older Women Little Good
COSMETIC
What to Do If You Have Unsightly Veins
Science May Banish Bad Hair Days
Gum Chewing May Cut Craving for Snacks
DENTAL, ORAL
Holistic Dentistry-My View
Study Links Osteoporosis Drugs to Jaw Trouble
Obesity Boosts Gum Disease Risk
DIABETES
Findings Challenge Tight Glucose Control for Critically Ill Patients
Chamomile Tea May Ward Off Diabetes Damage
Patients' Photos Help Boost Radiologists' Accuracy
DIET, NUTRITION
Antioxidant-Rich Foods Lose Nutritional Luster Over Time
Polyunsaturated Fats Really May Lower Heart Risk
More Whole Grains May Mean Less Fat
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Fertilizer Ban Makes a Difference
City Kids Find the Breathin' Is Easier Elsewhere
Improved Fungicides May Be Easier on Environment
EYE CARE, VISION
Action-Filled Video Games Boost Adult Vision
Time Teaches Brain to Recognize Objects
It's a Whole New Outlook for Cataract Patients
FITNESS
Basketball Star Details His Struggle With Gout
Exercise 30 Minutes a Day? Who Knew!
Higher Fitness Levels Tied to Lower Heart, Death Risks
GASTROINTESTINAL PROBLEMS
HRT Use Raises Risk of Stomach Trouble
Olive Oil May Protect Against Bowel Disease
New Yogurt May Ease Stomach Ulcers
GENERAL HEALTH
Can You Talk Your Way to Happy?
Have Fun This Summer, But DO Be Careful
Keep Fire Safety in Mind as You Celebrate
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
Subway Defibrillators Save Lives
Combating Myths About Seasonal Allergies
Save Your Aging Brain, Try Surfing The Web
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Review Confirms Links Between Diet, Heart Health
Estrogen May Help Men's Hearts
Too Much Red Meat May Shorten Life Span
INFECTIOUS DISEASE
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
Swine Flu Is Now a Pandemic Says W.H.O.
Swine Flu Closes Three Schools in NYC
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Scorpion Anti-Venom Speeds Children's Recovery
Frequent Feedings May Be Making Babies Fat
Older People at Greater Risk of Swine Flu Death
MEN'S HEALTH
Low Iron Levels Cut Cancer Risk in Men With PAD
More Vitamin C May Mean Less Chance of Gout
Varicose Veins May Mask Larger Problem
MENTAL HEALTH
The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
Meditation, Yoga Might Switch Off Stress Genes
Have a Goal in Life? You Might Live Longer
PAIN
Tai Chi May Help Ease Fibromyalgia
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
PHYSICAL THERAPY
PREGNANCY
Placebo Acupuncture Tied to Higher IVF Pregnancies
Before Conceiving, Take Folic Acid for One Full Year
Calcium Supplements Cut Blood Lead Levels During Pregnancy
SENIORS
For Older Walkers, Faster Is Better
Mediterranean Diet Plus Exercise Lowers Alzheimer's Risk
Many Cancer Survivors Don't Adopt Healthy Lifestyle
SEXUAL HEALTH
SLEEP DISORDERS
Meditation May Help Put Primary Insomnia to Bed
Lose Weight, Sleep Apnea May Improve
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Vitamin D Good for Breast Cancer Patients
Supplements Might Reduce Breast Cancer Risk
Being Active an Hour a Day Puts Brakes on Weight Gain
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Traditional Nonsurgical GERD Treatments Not Impressive

By Ed Edelson
HealthDay Reporter

FRIDAY, Jan. 23 (HealthDay News) -- Two traditional nonsurgical methods for correcting the anatomical flaw responsible for gastroesophageal reflux disease (GERD) produce only fair to middling results, a new study shows.

Experts also noted that newer procedures have essentially taken the place of the techniques examined in the study.

GERD is a condition in which acid from the stomach backs up into the esophagus, because the valve separating the two is faulty. Its problems include heartburn, voice symptoms and cough. It can be treated by medications such as proton pump inhibitors, which reduce acid levels, but best results require surgery to repair the valve.

But surgery has its own problems, so nonsurgical methods of treating GERD have long been used. A new report in the January issue of the Archives of Surgery described how the two methods were put to the test in a study of 124 people treated at Emory University in Atlanta.

Of these, 68 underwent radiofrequency therapy, in which a beam of energy waves is aimed at the muscles of the esophagus and stomach to improve the function of the valve. The others had full-thickness plication, in which a long, narrow tube called an endoscope carries in instruments to suture the junction between the stomach and the esophagus.

In an average follow-up of six months, the incidence of moderate to severe heartburn decreased from 55 percent to 22 percent among those undergoing radiofrequency therapy. Use of GERD drugs decreased from 84 percent to 50 percent, and there were fewer reports of swallowing difficulties, voice symptoms and cough.

In the full-thickness plication group, moderate to severe heartburn decreased from 53 percent to 43 percent. Medication use decreased from 95 percent to 43 percent, and decreases were reported for voice symptoms and swallowing difficulties.

However, it is an underwhelming report, said Dr. Anthony A. Starpoli, a gastroenterologist at Lenox Hill Hospital in New York City, not only because better results were hoped for, but also because both methods are considered obsolete.

"We're talking about older, and not commercially available, techniques that have been supplanted by newer and more effective techniques to perform incisionless surgery," Starpoli said.

The full-thickness plication method was taken off the market last year, and radiofrequency therapy is rarely used in major centers, he noted.

Two new techniques now are used in many medical centers. One, whose brand name is EsophyX, allows surgical repair of the valve without an incision, with instruments inserted through the mouth.

A second technology, the EndoCinch, also uses instruments inserted down the throat, so that tissues can be stitched together to improve function of the valve.

"This EsophyX technique allows for robust remodeling of the anti-reflux barrier," said Starpoli, who uses it himself. Between 70 percent and 80 percent of those undergoing the procedure stop using GERD drugs, which is close to the 90 percent of those having standard surgery, he said.

"I probably do 100 reflux surgeries a year, and probably half to a third would be candidates for this [EsophyX]," said Dr. Reginald Bell, an assistant clinical professor of surgery at the University of Colorado Health Sciences Center in Denver.

That method is less aggressive than standard surgery, and so it is attractive to "a host of patients under medical [drug] therapy to whom current surgical technique does not appeal," Bell said. "Ordinary surgery is more aggressive than they need, their symptoms are not so bad that they need to go to surgery. This is really the first device to do internally what we know we can do externally."

Reports on the EndoCinch technique have been less enthusiastic; several European studies have said the beneficial effects of the procedure decrease or disappear with time.

More information

The full GERD story is available through the U.S. National Library of Medicine.



SOURCES: Anthony A. Starpoli, M.D., gastroenterologist, Lenox Hill Hospital, New York City; Reginald Bell, M.D., assistant clinical professor, surgery, University of Colorado Health Sciences Center, Denver; January 2009, Archives of Surgery

Last Updated: Jan. 23, 2009

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