ALLERGY, RESPIRATORY
Keep Asthma, Allergies at Bay for the Holidays
'Safe' Ozone Levels May Not Be for Some
Combating Myths About Seasonal Allergies
ALTERNATIVE MEDICINE
Regular Yoga May Improve Eating Habits
Awareness of Alternative Therapies May Be Lacking
Tai Chi: An Ideal Exercise for Many People with Diabetes
ANIMAL CARE
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Beware of Dog Bites
Separation Anxiety, Canine-Style
BONES & JOINTS
Many Americans Fall Short on Their Vitamin D
Alleviating Rheumatoid Arthritis
Exercise Key Player in Knee Replacement Recovery
CANCER
Massage Therapy Helps Those With Advanced Cancer
Ginger Can Ease Nausea From Chemotherapy Treatments
Supplements Might Reduce Breast Cancer Risk
CAREGIVING
Study of Everest Climbers Questions Oxygen Use
Study Links Pesticides to Birth Defects
Health Tip: Benefitting From Adult Day Care
CIRCULATORY SYSTEM
Vitamins Do Older Women Little Good
Night Shift Work Hard on the Heart
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
COSMETIC
Contact Lenses Boost Kids' Self-Image
Gum Chewing May Cut Craving for Snacks
New Genetic Links to Baldness Discovered
DENTAL, ORAL
Amino Acid May Be Key to Strong Teeth
Rheumatoid Arthritis May Harm Gums
Hormones May Be to Blame for Women's Cavity Rates
DIABETES
Doctors Urged to Screen Diabetics for Sleep Apnea
Strict Blood Sugar Lowering Won't Ease Diabetes Heart Risk
Americans Consuming More Sugary Beverages
DIET, NUTRITION
Coffee or Tea Consumption May Lower Stroke Risk
Probiotics Are The Good Guys
Go Healthy, Not Hungry for Holiday Eating
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Freckles, Moles May Indicate Risk for Eye Cancer
Greener Neighborhoods Mean Slimmer Children
City Kids Find the Breathin' Is Easier Elsewhere
EYE CARE, VISION
Blood Sugar Control Helps Diabetics Preserve Sight
Too Much Sun, Too Few Antioxidants Spell Eye Trouble
Omega-3 Foods May Lower Eye Disease Risk
FITNESS
Exercise Cuts Lung Cancer Risk in Ex-Smokers by 45%
Exercise Key Player in Knee Replacement Recovery
Go To Work But Skip The Car
GASTROINTESTINAL PROBLEMS
Soothing Imagery May Help Rid Some Kids of Stomach Pain
Bowel Prep Harder on Women Than Men
Intestinal Bacteria Trigger Immune Response
GENERAL HEALTH
Vitamin D Best Taken With Largest Meal of Day, Study Finds
Should the FDA Regulate Tobacco?
Heal Your Life® Tips for Living Well
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
E-Mailing Your Way to Healthier Habits
'Cell Phone Elbow' -- A New Ill for the Wired Age
Using Light Therapy to Silence Harmful Brain Activity
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Implanted Defibrillators Boost Long-Term Survival
Coffee Is Generally Heart-Friendly
Toothbrushing May Stave Off Heart Woes
INFECTIOUS DISEASE
Hand Washing 10 Times a Day May Help Keep Flu Away
Bacterial Infections May Succumb to Honey
Poor Restroom Cleaning Causes Cruise-Ship Sickness
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
More Calcium And Dairy Products in Childhood Could Mean Longer Life
Too Many Infants Short on Vitamin D
Scorpion Anti-Venom Speeds Children's Recovery
MEN'S HEALTH
Varicose Veins May Mask Larger Problem
Countdown to Hair Loss
Strenuous Daily Workout May Keep Cancer at Bay
MENTAL HEALTH
Keeping a Healthy Holiday Balance
Keeping Mentally Active Seems To Keep The Brain Active
Breast-Fed Baby May Mean Better Behaved Child
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Alleviating Rheumatoid Arthritis
Are We Exercising Pain Away? Not So Much.
PHYSICAL THERAPY
PREGNANCY
For Baby and Mom Alike, Breast-Feeding May Be Best
Alternative Treatments May Boost IVF Success
Pre-Pregnancy Weight Linked to Babies' Heart Problems
SENIORS
The Healthy Habits of Centenarians
Tai Chi May Help Ease Fibromyalgia
Want Better Health in the New Year, Add Exercise to Your Day
SEXUAL HEALTH
SLEEP DISORDERS
Sleeping Could Help Women Lose The Baby Fat
6 to 8 Hours of Shut-Eye Is Optimal for Health
Moderate Aerobics May Ease Insomnia Symptoms
WOMEN'S HEALTH
Soy May Not Lead to Denser Breasts
Acupuncture May Help Relieve Polycystic Ovary Syndrome
Flame-Retardant Chemical Linked to Conception Problems
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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