what should I expect from TIF?

I did not have the TIF but I would get the manometry to make sure you don't have a motility problem before surgery. If you do, it can cause a bunch of problems after surgery. It's not a fun test at all but it's only an hour and can show a lot. Just have them numb your throat, it makes it much more tolerable. I've had it both ways, numb and not numb.

I've been doing some research on TIF myself (and am scheduled to see a surgeon later next month).

This is an insurance site and seems to claim that the TIF sutures don't hold too well in the long term:

blue.regence.com/trgmedpol/surgery/sur110.html

I'd appreciate comments on this from people who've had experience with TIF.

Thanks.

I have acid reflux and stomach pains.   I also have a hiatal hernia.

The stomach pains come and go. I have also had gastritis 6 times, but the current pain comes and goes. I, too sometimes think the pains are caused by the Nexium, but I will go weeks without the pain. I am also taking Carafate and twice a day swallow a Mylanta cocktail, which really helps relieve the pain. I have been on Nexium for 10 years (2 x day, 40 mg.). The heartburn was relieved when I went on the 2 doses of Nexium, but returned last May. I have taken every PPI there is and Nexium was the only Rx that helped. I have never been totally without pain for 11 years. Either it's the heartburn or the stomach pains and painful bloating.

I thought the LINX procedure was only available in Europe???

My symptoms:

Feb11=> thick mucous in the throat, esophagus ache (no heartburn)
---PPIs/H2s started
Mar11=> Dysphagia, PPIs side effects started: knee-aches, depression, anxiety, insomnia
Apr=> Esophagus ache cleared. Throat symptoms remained. Side-effects on meds continued
---PPIs/H2s stopped after various experiments and combinations.
May/June/July11=>Severe throat symptoms (no heartburn).
---Experiemented with various other meds: gabapentin, antidepressants, benzos etc. Couldn't stay on them.
Aug/Sep/Oct11=>Throat symptoms subsided - heartburn symptoms started in chest + mouth.
Nov11-Present=>Heartburn symptoms (chest discomfort, warm / cool pain/aches around the LES, achiness in the throat, bitter taste in mouth). Frequency of symptoms reduced - sometimes I get a full day of relief. But, they promptly come back.

I've had 2 endoscopies (normal), 2 manometries (normal) and 2 ph tests (1 abnormal and 1 normal). Going for another pH test (dual impedance) end of this month.

Yes, I've done a lot of research on LINX. However, I am not comfortable with having a foreign object sitting on the soft tissue of the esophagus ... near the vagus nerve ... esp. when this procedure is so new. Looks like Nissen is the best time-tested solution. However, the possible side effects are quite scary. TIF seems like a good middle ground .. however, is fairly new and some studies claim it is not as durable as Nissen.

At this point though, my tests don't show enough evidence of reflux. 99.99% of the people with my level of symptoms do very well on the PPIs. So, I am an absolute outlier ("outlier within the outliers" is how one dr. described me) ... who has mild to moderate GERD but needs a heavy duty surgery to fix it.

I am a 42 year old male .. otherwise healthy (no other problems).

Thats my story so far ...

I was a little scared about the manometry myself, but it really wasn't as bad as I expected. If you just close your eyes, it'll be over before too long. Its really when they first put it in that is uncomfortable. Once its in there and during the test it is not bad. I'd do it again tomorrow if I had to without any worry.

I was quite ok with the manometry as well .. not a big deal .. some throat gaggy feeling .. but it gets over fairly quickly. Pain that is not going to last beyond a short amount of time does not bother me ...

GERD on the other hand they say - is progressive and chronic. Now that scares me the most - esp. when I haven't figured out any cause and effect of these symptoms. I've tried several natural things .. some things help .. but nothing seems to fix it.

Carolanno .. in my case the procedure didn't last more than 15-20 minutes. They give you a cup of water with a straw .. and you take several sips and swallow it when they tell you to .. and they measure the various signals from the peristalsis (which you can also view on the screen). In fact, I distracted myself by watching the graph on the screen!

I have similar background/history as PPI-LESS. I'm 45 and have been good for the most part on Prilosec for years, but it does seem to be progressing and when it's bad, it's BAD!  I've also recently have seen a surgeon and while the Nissen is an option, the TIF seems to be recommended by surgeon. I want this decision to be a no-brainer, and I really want to go with the less invasive TIF, but can't seem to pull the trigger.

Just thought I'd make a quick point -- the link PPI-LESS provided concerning studies of some newer reflux surgery methods (including the TIF), did mention from one study the loss of sutures. However, if you read more closely, the EndoCinch procedure was included in this, with no distinction between that and the TIF. From what I know, the EndoCinch procedure is no longer being done by reputable surgeons...presumably because of this issue. I know of no direct studies condemning the TIF.

-Bruce

The nissen is not a 'one shot' deal. I've had 3, first 2 were too loose. Fourth one coming soon. I am not anywhere near the normal case but it can be redone.