ALLERGY, RESPIRATORY
Traffic, Dust Linked to Asthma in Kids
Molecule in Skin May Link Eczema and Asthma
Keep Asthma, Allergies at Bay for the Holidays
ALTERNATIVE MEDICINE
Maggots as Good as Gel in Leg Ulcer Treatments
Acupuncture May Not Help Hot Flashes
Ginkgo No Shield Against Alzheimer's
ANIMAL CARE
Animals Respond to Acupuncture's Healing Touch
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Studies Struggle to Gauge Glucosamine's Worth
Health Tip: Back Pain in Children
Body Fat, Muscle Distribution Linked to RA Disability
CANCER
Scams and Shams That Prey on Cancer Patients
Where You Live May Affect Your Cancer Diagnosis
Smoking Ups Risk of Second Breast Cancer
CAREGIVING
Coordination Has Led to Quicker Heart Treatment
Hospital Practices Influence Which Moms Will Breast-Feed
Rapid Infant Weight Gain Linked to Childhood Obesity
CIRCULATORY SYSTEM
Salt Boosts Blood Pressure in High-Risk Patients
An Apple a Day May Help Keep Heart Disease Away
Firefighters Have Narrower-Than-Normal Arteries, Study Finds
COSMETIC
Health Tip: After Liposuction
With Psoriasis, the Internet May Offer Hope
Science May Banish Bad Hair Days
DENTAL, ORAL
Biological Product Shows Promise Against Gum Disease
Rheumatoid Arthritis May Harm Gums
Study Links Osteoporosis Drugs to Jaw Trouble
DIABETES
Boosting Vitamin D Can Do a Heart Good
Exercise Protects Black Women From Type 2 Diabetes
Fructose-Sweetened Drinks Up Metabolic Syndrome Risk
DIET, NUTRITION
Regular Yoga May Improve Eating Habits
Adults Need To Get Thier Food Facts Straight
The High-Fructose Corn Syrup (HFCS) Debate
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Hairspray Exposure Ups Risk for Birth Defect in Sons
Pregnant Rural Women More at Risk
Vitamin D Deficit May Trigger MS Risk Gene
EYE CARE, VISION
Green Tea May Ward Off Eye Disease
Kids Who Spend More Time Outdoors Have Better Vision
Americans Losing Sight of Eye Health
FITNESS
Super Bowl Loss Can 'Kill' Some Fans
School Phys. Ed. Injuries Up 150 Percent
As Temperature Plummets, It's Still Safe to Exercise
GASTROINTESTINAL PROBLEMS
Japanese Herbals May Ease Gastro Woes
Peppermint Oil, Fiber Can Fight Irritable Bowel
Gum Chewing May Speed Colon Surgery Recovery
GENERAL HEALTH
Maximize Your Run
Heal Your Life® Tips for Living Well
Pay Attention to Signs That Say You're Too Fatigued to Drive
HEAD & NECK
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
Magnet Therapy May Ease Hard-to-Treat Depression
Airport Full Body Scanners Pose No Health Threat: Experts
Combating Myths About Seasonal Allergies
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Too Much Red Meat May Shorten Life Span
Rheumatoid Arthritis a Threat to the Heart
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
INFECTIOUS DISEASE
Viral Infection Might Trigger High Blood Pressure
Swine Flu Is Now a Pandemic Says W.H.O.
Surgical Masks Could Prevent Flu, Maybe
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Breast-Feeding May Protect a Woman's Heart
Stomach Germ May Protect Against Asthma
Green Tea May Help Brain Cope With Sleep Disorders
MEN'S HEALTH
Drinking Green Tea May Slow Prostate Cancer
Exercise May Prevent Prostate Cancer: Study Shows
Low Vitamin D Levels May Boost Men's Heart Attack Risk
MENTAL HEALTH
Keeping Mentally Active Seems To Keep The Brain Active
Have a Goal in Life? You Might Live Longer
Optimism May Boost Immune System
PAIN
Tai Chi May Help Ease Fibromyalgia
'Cell Phone Elbow' -- A New Ill for the Wired Age
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Pregnant Women Exposed To Certain Pollutants Could Lower Childs IQ
Yoga's Benefits Outweigh Risks for Pregnant Women
Pre-Pregnancy Weight Linked to Babies' Heart Problems
SENIORS
Living Alone Increases Odds of Developing Dementia
As You Age, Better Health Means Better Sex
Memory Loss Help from Brain Supplement Prevagen
SEXUAL HEALTH
SLEEP DISORDERS
Moderate Aerobics May Ease Insomnia Symptoms
Better Sleep, Grades Seem to Go Up
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Natural Oils Help Lower Body Fat For Some
Exercise Boosts Bone Density in Breast-Feeding Moms
Heal Your Life® Tips for Living Well
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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