At Tennessee Heartburn Clinic, we provide complete care for digestive system disorders. Here are some frequently asked questions to learn more.
Tennessee Heartburn Clinic Frequently Asked Questions
How effective are pharmaceuticals at managing Gastroesophageal Reflux Disease (GERD)?
Pharmaceuticals like PPIs and H2 blockers can be very effective at treating acidic symptoms of GERD for some patients. However, medications are usually quite ineffective managing symptoms such as regurgitation of liquids or solid foods back into the esophagus. Thus, the risks of injury to the esophagus may not be controlled with medication alone.
What diagnostic tests might be used to diagnose my GERD?
Any one or more of the following my be needed to diagnose and confirm GERD in certain patients:
- Upper GI endoscopy (EGD)
- Esophageal acid monitoring (pH monitoring)
- Barium esophagram
- Esophageal manometry – a test to detect problems with movement and pressure in the esophagus
- Medical tests, such as an electrocardiogram (EKG) and blood work to exclude other medical problems that could mimic GERD symptoms
When should I consider surgery?
Dr. Mark Fox will help you determine if surgery is appropriate for your condition. We perform minimally-invasive laparoscopic surgery and an incisionless procedure called Transoral Incisionless Fundoplication (TIF) that helps keep the esophagus in the right place and stops the backward flow of fluid (reflux).
If your current GERD therapies are ineffective, and you are concerned about the side effects and adverse long-term consequences of medication, we’re happy to discuss other treatment options.
What is the TIF procedure and how many have been performed?
Transoral Incisionless Fundoplication, or TIF, helps keep the esophagus in the right place and stops the backward flow of fluid (reflux). Dr. Fox has performed more than 14,000 TIF procedures at Tennessee Heartburn Clinic, more than any center in this part of the U.S. The device used during the TIF procedure was FDA approved in 200. It’s designed for the treatment of chronic GERD and to narrow the gastroesophageal junction (the point where the end of the esophagus joins the stomach) and reduce hiatal hernias.
Is the TIF procedure covered by my health insurance?
Medical insurance coverage and third-party payers for TIF are increasing. Many plans require you or your surgeon to submit paperwork for pre-authorization since this is an elective procedure. Patients may be asked to pay a deposit prior to scheduling surgery which is refundable when their insurance covers and reimburses for the procedure.
Are there diet restrictions following the TIF procedure?
Since TIF alters the lower esophagus and upper stomach, healing often takes a few weeks. For the first three weeks, patients are on a soft diet and encouraged to eat slowly, chewing food very well. They’re also instructed to eat multiple small meals daily rather than trying to eat larger meals three times a day. Most patients tolerate these suggestions very well, and weight can be maintained.
Is TIF considered investigational?
Absolutely not. Some insurance companies and third-party payers are very slow to review literature about newer procedures and treatments. When a new procedure is introduced, they often assign a designation of “investiagtional” to the procedure so they can monitor its growth and use. This often means patients must endure paperwork, appeals, and delays on occasion when working with their insurance/payers. As is evidenced by various insurance companies and even some Medicare payers recognizing and paying for TIF, this procedure has long since not been investigational or experimental.
What is Barretts Esophagitis?
This is a condition that occurs from chronic reflux of stomach contents into the esophagus. Reflux damages the esophageal lining and changes the cell type lining the esophagus. Given time, this change can progress to a cancer in the lower esophagus. It cannot be predicted which patients will develop cancer. Therefore, frequent monitoring by endoscopy is required.
Do I need a referral to see Dr. Fox at Tennessee Heartburn Clinic?
No referral is needed to make an appointment to see Dr. Fox unless required by your insurance company. Please check your policy.
For any questions about these frequently asked questions, our gastroenterology services, or to schedule an appointment, call (931) 484-5141.