ALLERGY, RESPIRATORY
Molecule in Skin May Link Eczema and Asthma
Folic Acid Might Offer Allergy Relief
Herbal Remedy Could Halt Peanut Allergy
ALTERNATIVE MEDICINE
Spot light on Dani Antman New Lionheart teacher
Supplement Hampers Thyroid Cancer Treatment
Green Tea May Help Brain Cope With Sleep Disorders
ANIMAL CARE
Safe Toys for Dogs
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Beware of Dog Bites
BONES & JOINTS
More Faces Being Spared in Motor Vehicle Accidents
Study Shows Exercise Shields Against Osteoporosis
Extra Pounds in Mid-Life Affect Later Mobility
CANCER
Sharing Cancer Info May Be Empowering
Supplements Might Reduce Breast Cancer Risk
Tanning Beds Shown To Raise Cancer Risk, Study Says
CAREGIVING
Hospital Practices Influence Which Moms Will Breast-Feed
Most Women Struggle With Rising Health Care Costs
Baby's Sleep Position May Not Affect Severity of Head Flattening
CIRCULATORY SYSTEM
Drink a Little Wine, Live a Little Longer
Firefighters Have Narrower-Than-Normal Arteries, Study Finds
Salt Boosts Blood Pressure in High-Risk Patients
COSMETIC
Science May Banish Bad Hair Days
With Psoriasis, the Internet May Offer Hope
Gum Chewing May Cut Craving for Snacks
DENTAL, ORAL
A Sweet Way to Shield Baby's Teeth
Holistic Dentistry-My View
Gum Disease May Reactivate AIDS Virus
DIABETES
Strict Blood Sugar Lowering Won't Ease Diabetes Heart Risk
Exercise Protects Black Women From Type 2 Diabetes
Boosting Vitamin D Can Do a Heart Good
DIET, NUTRITION
Eating Free Range
Caffeine May Offer Some Skin Cancer Protection
Fruits, Vegetables, Teas May Cut Smokers' Cancer Risk
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Pesticides Linked to Parkinson's
Global Warming Biggest Health Threat of 21st Century, Experts Say
Database Helps Assess Your Breast Cancer Risk
EYE CARE, VISION
Eye Disease, Cognitive Decline Linked in Study
Eye Test Could Spot Diabetes Vision Trouble Early
Sports Eye Injuries Leading Cause of Blindness in Youths
FITNESS
Bursts of Vigorous Activity Appear to Be a 'Stress-Buffer'
Exercise Extends Life of Kidney Patients
Consciousness Helps the Mind and Body Work Together
GASTROINTESTINAL PROBLEMS
New Yogurt May Ease Stomach Ulcers
Bowel Prep Harder on Women Than Men
Japanese Herbals May Ease Gastro Woes
GENERAL HEALTH
Healthy Eating While On Vacation
Regular Yoga May Improve Eating Habits
Coffee Cuts Liver Scarring in Hepatitis C
HEAD & NECK
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
Using Light Therapy to Silence Harmful Brain Activity
Save Your Aging Brain, Try Surfing The Web
Combating Myths About Seasonal Allergies
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Rheumatoid Arthritis a Threat to the Heart
Using Light Therapy to Silence Harmful Brain Activity
Kids With Vitamin D Deficiency Linked to Heart Trouble
INFECTIOUS DISEASE
Grapefruit Compound Inhibits Hepatitis C Virus
More Medicinal Uses for Pomegranate
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Frequent Feedings May Be Making Babies Fat
Better Sleep, Grades Seem to Go Up
Older People at Greater Risk of Swine Flu Death
MEN'S HEALTH
Exercise May Prevent Prostate Cancer: Study Shows
Could Chinese Herb Be a Natural Viagra?
Whole Grains, Bran May Fight Hypertension in Men
MENTAL HEALTH
Teen Internet Addicts More Likely to Self-Harm: Study
Daily dose of beet juice promotes brain health in older adults
Bullying Seems to Affect Kids Years Later
PAIN
Alleviating Rheumatoid Arthritis
Acupuncture, Real or Fake, Eases Back Pain
Tai Chi May Help Ease Fibromyalgia
PHYSICAL THERAPY
PREGNANCY
Before Conceiving, Take Folic Acid for One Full Year
Acupuncture May Ease Depression During Pregnancy
Yoga's Benefits Outweigh Risks for Pregnant Women
SENIORS
Save Your Aging Brain, Try Surfing The Web
Older People at Greater Risk of Swine Flu Death
Nighttime Urination Linked to Higher Death Rate Among Elderly
SEXUAL HEALTH
SLEEP DISORDERS
Pay Attention to Signs That Say You're Too Fatigued to Drive
Meditation May Help Put Primary Insomnia to Bed
Better Sleep, Grades Seem to Go Up
WOMEN'S HEALTH
Calcium Helps Ward Off Colon Cancer
Natural Relief for Painful Menstrual Cramps
Omega-3 May Reduce Endometriosis Risk
Add your Article

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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