ALLERGY, RESPIRATORY
Air Pollution May Raise Blood Pressure
Using Music and Sports to Improve Kids' Asthma
New Spray Could Benefit Cystic Fibrosis Patients
ALTERNATIVE MEDICINE
Pharoah's Wine Jar Yields Medicinal Secrets
Meditation, Yoga Might Switch Off Stress Genes
Ginkgo No Shield Against Alzheimer's
ANIMAL CARE
Separation Anxiety, Canine-Style
'Comfort Dogs' Come to Emotional Rescue
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
BONES & JOINTS
Alleviating Rheumatoid Arthritis
Weight Loss Might Not Curb Knee Arthritis
Studies Struggle to Gauge Glucosamine's Worth
CANCER
Antioxidants Pose No Melanoma Threat
Adding Garlic Might Cut Cancer Risk
Omega-3 May Safely Treat Precancerous Bowel Polyps
CAREGIVING
U.S. Mental Health Spending Rises, But Many Still Left Out
Many Hospital Patients Can't ID Their Doctors
Tiniest Babies Carry Biggest Costs
CIRCULATORY SYSTEM
Bad Marriages Harder on Women's Health
Obesity Linked to Heart Failure Risk
Support Network May Play Role in Benefits of Drinking
COSMETIC
Study Evaluates Laser Therapies for Hair Removal
Contact Lenses Boost Kids' Self-Image
What to Do If You Have Unsightly Veins
DENTAL, ORAL
Biological Product Shows Promise Against Gum Disease
Rheumatoid Arthritis May Harm Gums
Study Links Osteoporosis Drugs to Jaw Trouble
DIABETES
Out-of-Control Blood Sugar May Affect Memory
Whole Grains Take a Bite Out of Type 2 Diabetes Risk
Arthritis Hits More Than Half of Diabetics
DIET, NUTRITION
Pesticides on Produce Tied to ADHD in Children
More Educated Choose Healthier Foods, But Pay More
Many Cancer Survivors Don't Adopt Healthy Lifestyle
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Genetics, Environment Shape Sexual Behavior
Dementia Underestimated in Developing Countries
'Safe' Ozone Levels May Not Be for Some
EYE CARE, VISION
When Gauging Age, the Eyes Have It
Thyroid Problems Boost Glaucoma Risk
Eye Problems, Hearing Loss May Be Linked
FITNESS
Being Active an Hour a Day Puts Brakes on Weight Gain
Any Exercise Good After a Heart Attack
Avoiding a Holiday Season of Discontent
GASTROINTESTINAL PROBLEMS
HRT Use Raises Risk of Stomach Trouble
Intestinal Bacteria Trigger Immune Response
Japanese Herbals May Ease Gastro Woes
GENERAL HEALTH
Eat Light - Live Longer
Pesticides and How to Affordably Eat Organic or Reduce Pesticide Consumption
A Little Alcohol May Stave Off Alzheimer's
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
Imaging Sheds Light on How Acupuncture Works
Combating Myths About Seasonal Allergies
Magnet Therapy May Ease Hard-to-Treat Depression
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Fructose Boosts Blood Pressure, Studies Find
Obese People Seem to Do Better With Heart Disease
Years of Heavy Smoking Raises Heart Risks
INFECTIOUS DISEASE
Viral Infection Might Trigger High Blood Pressure
Older Adults May Have Some Immunity to Swine Flu
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Dangerous Toys Still on Store Shelves, Report Finds
Mom and Baby Alike May Benefit From Exercise
Fussy Babys Could Be Out Of Your Control
MEN'S HEALTH
Whole Grains, Bran May Fight Hypertension in Men
Exercise May Prevent Prostate Cancer: Study Shows
Eating Fast Until Full Triples Overweight Risk
MENTAL HEALTH
Musicians' Brains Tuned to Emotions in Sound
Consciousness Helps the Mind and Body Work Together
Music Soothes Anxiety as Well as Massage Does
PAIN
Alleviating Rheumatoid Arthritis
Acupuncture, Real or Fake, Eases Back Pain
Tai Chi May Help Ease Fibromyalgia
PHYSICAL THERAPY
PREGNANCY
Prenatal Stress May Boost Baby's Asthma Risk
Calcium Supplements Cut Blood Lead Levels During Pregnancy
Acupuncture May Ease Depression During Pregnancy
SENIORS
For a Healthier Retirement, Work a Little
15-Point Test Gauges Alzheimer's Risk
Keeping Mentally Active Seems To Keep The Brain Active
SEXUAL HEALTH
SLEEP DISORDERS
Meditation May Help Put Primary Insomnia to Bed
Moderate Aerobics May Ease Insomnia Symptoms
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
A Brisk Pace May Keep Stroke at Bay
Steady Weight Gain Boosts Late-Life Breast Cancer Risk
Frankincense Provides Relief for Osteoarthritis
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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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