In Oct. 21 IssueBy Derek AaronTimes Journal Editor
A new incisionless procedure available at Russell County Hospital could end up helping many locals who struggle with acid reflux problems, according to Dr. Vijay Jain, general surgeon at the hospital.
The procedure is called Transoral Incisionless Fundoplication, or TIF for short, and is billed as an effective solution for chronic acid reflux.
"A lot of people have flux disease in our area," Jain said. "I think we are going to be the only hospital in this area, for the time being, offering this."
Jain said the wall that separates the esophagus from the stomach is the source of most acid reflux problems. After food travels through the esophagus to the stomach, sometimes the wall does not function properly leaving acid from the stomach to slip up through the wall opening and into the esophagus, ending in heartburn, chest pain or other acid reflux problems for the person.
"Traditionally we have been treating them with medicines and medicines work pretty good in the early stages of the disease," Jain said. He said medicines such as Prilosec, Prevacid, Pepcid and Nexium have worked really well in suppressing the acid but that the medication does not help restore the wall where the esophagus ends and the stomach begins.
The only option to restore the wall in the past has been surgery, which could lead to long stays in the hospital and many days of from work for patients.
"Since it is a pretty major surgery, people just opt to deal with it with medicines," Jain said, something he said could lead to long-term effects in the future, malabsorption of certain nutrients and osteoporosis just to name a few.
"This is the most effective technique which has been advanced and is a great technological advance that we can do this procedure now with the endoscope," he said.
With a camera at the end of the scope, Jain is able to go through the mouth and down the throat in an effort to repair the wall that is allowing acid up into the esophagus.
The procedure reconstructs the antireflux valve and restores the body's natural protection against reflux.
He said research has shown that following the TIF procedure, 75 percent of patients have not had to take any more medication for acid reflux.
"It is not recommended for minor reflux because everyone sometimes can have a little heartburn and then it goes away," he said. "It is for people who have been taking anti-reflux medicine for a long period of time."
He said extreme cases of acid reflux disease would still have to have regular surgery because of the hernia that usually develops in more severe cases.
Jain, who has performed various endoscopies over his 30-year career, recently traveled to Northwestern University in Chicago with his assistant Greg Mann, to learn about the new TIF procedure.
"It was just an additional technique that I needed to learn," he said. "The beauty of this procedure is no incisions, no post-operative stay in the hospital, just overnight … and the recovery time is fast, usually people can get back to work between three and seven days rather than a four to five week layoff."
Jain said one of his first priorities will be to educate the local family physicians on this procedure so that they, too, can give information to their patients on it and whether or not they think it to be an option. He said that he believes around 300 people have some type of acid reflux problem in Russell County.
"A lot of people just deal with it because they have no other option," Jain said of the procedure.
Jain said he hopes to treat 10 percent of those patients with this procedure in the first year.
Some benefits of TIF are: no external skin incisions or scarring, no internal cutting or dissecting of the natural anatomy, more rapid recovery, fewer adverse events and complications, does not limit future treatments options and it can be revised if required.
According to literature provided by Jain, TIF has been proven safe in use in thousands of procedures worldwide with only minimal side effects.
TIF is performed under general anesthesia and requires one to not eat or drink for several hours prior to the procedure with the procedure itself generally taking less than one hour. In the following days patients may experience discomfort in their stomach, chest nose and throat and will need to restrict physical activity for the first week and will be given dietary guidelines to help maximize success as the tissue heals.
Jain has been specially trained to perform the TIF procedure and has had hands-on training with certified TIF trainers.
This procedure is covered by most insurance plans and is covered by Medicaid. To speak with Dr. Jain on TIF or acid reflux disease he can be reached at Russell County Hospital at 270-866-9333.