Frequently Asked Questions
Q. How effective are pharmaceuticals at managing GERD?
A. Pharmaceuticals like PPIs and H2 blockers can be very effective at treating the acidic symptoms of GERD for some patients. Other patients may be experiencing breakthrough GERD episodes, may have to sleep sitting up or may have symptoms not related to acidity such as regurgitation or asthma while on pharmaceuticals.
For short term, intermittent reflux episodes, pharmaceuticals may be ideal; however, most pharmaceuticals are only indicated for short term use (4-8 weeks) to allow the esophagus to heal and are not indicated as a life long therapy.
Q. What medical diagnostic tests might be used to diagnose my GERD?
A. Any one or more of the procedures listed below may be used to diagnose GERD.
- Upper Endoscopy (Esophagogastroduodenoscopy, or EGD) - Most patients will be asked to undergo an EGD procedure. During your EGD, the physician will use a video device called a gastroscope inserted through your mouth to examine your esophagus, stomach and the beginning portion of the small intestine. This procedure will typically take 10-20 minutes.
- pH Monitoring - Some patients will be required to do pH monitoring. During pH monitoring, a small monitoring device is placed in the esophagus. Over a period of time the device records the amount of time the esophagus is acidic, indicating reflux of acidic stomach contents.
- Barium Esophagram/ Upper GI Series - While not a true diagnostic tool for GERD, it is a good diagnostic test for hiatal hernia, which can contribute to GERD.
- Esophageal Manometry - Used to measure and record muscular pressure to determine if the lower esophageal sphincter (LES) is functioning properly. A small tube is guided through the patient's nose into the esophagus. A sensor connected to the tube measures the muscular pressure in the esophagus and stomach.
While Barium Series and Manometry tests have only limited usefulness in diagnosing GERD, your doctor may recommend one when the patient has certain symptoms, particularly difficulty swallowing.
Q. When should I consider surgical intervention?
A. Ask you doctor whether surgical intervention, either laparoscopic or the new TIF incisionless procedure, might be appropriate for you if your current GERD therapies are ineffective and you are concerned about the possible adverse effects of long-term use of pharmaceuticals.
Q. How many TIF procedures have been performed?
A. Worldwide over 1,000 TIF procedures have been performed to date and it is rapidly gaining acceptance as a frontline treatment for moderate to severe GERD.
Q. Is the EsophyX device used for the TIF procedure FDA cleared?
A. Yes, it was FDA cleared in 2007 for the treatment of chronic gastroesophageal reflux disease (GERD) in patients who require and respond to pharmacological therapy. It is also indicated to narrow the gastroesophageal junction and reduce hiatal hernia ≤ 2cm in size in patients with symptomatic chronic gastroesophageal reflux disease.
Q. Is the TIF procedure covered by my health insurance?
A. TIF procedures have been covered by Medicare and select private health plans. Private health plans typically require you or your surgeon to submit paperwork for preauthorization of an elective surgery.
Q. How can I find a TIF trained surgeon?
A. Trained and certified TIF procedure physicians can be found in the online TIF Physician Directory at EndoGastric Solutions, Inc.