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Esophyx - any recent results?

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Posted 3/25/2015 8:47 PM (GMT 0)
Hi,

I've done some searching on the forums and most of the Esophyx (TIF - Transoral Incisionless Fundoplication) results I'm seeing are from a few years ago. Anyone out there have the procedure done recently? How did it go?

I'm considering Esophyx as an alternative to full Nissen Fundoplication. I've been dealing with GERD and LPR that has become much worse over the past three years, to the point where I'm having dysphagia, frequent hoarseness/coughing, post-nasal drip, and other unpleasant issues. I also have 6cm of non-dysplastic Barrett's Esophagus.

So far, I've been unable to take PPIs - tried Dexilant, Prevacid, and Prilosec, all of which gave me terrible nausea and stomach cramping within a few days of starting and never let up. I've been using Zantac and Pepto Bismol to try and control things, with moderate results. I've also changed my diet considerably and lost over 100 pounds. But the cough, throat clearing, and swallowing difficulty remains and I've been sleeping sitting up on the couch for the past six months.

I feel it's time to consider surgical options and the surgeon I consulted with in Tampa recommended TIF instead of NF or Stretta for me. At this point, I just need to know if anyone out there is having good results from their procedure. Some of the posts I've read online tell a negative story, but I suspect we'll hear more about the bad than the good. Those who have positive results may not go online and talk much about it...they probably just go on with their lives.

Any info is greatly appreciated.

Thanks!
Posted 3/26/2015 11:28 PM (GMT 0)
I suffered with GERD for 10 years and took most of the PPIs, changed my diet and still had problems with reflux. I went to two different gastroenterologists and each did two endoscopes. Both sent me home saying I was not too bad and live with it.

I finally went to a Heart Burn Center at a local hospital. They did a 24 hour pH test and my reflux was severe. I had the TIF done in April of 2011, almost 4 years ago. I carefully followed the diet after the TIF and followed all of the doctor's orders during recovery.

After recovery, I stopped taking Nexium and gradually changed back to a normal diet. After four years I eat and drink what I want, I am sleeping much better, don't have that bad sour taste in my mouth and I am pleased with my TIF.

I wish you well with your decision and correcting your reflux problem. It is a miserable problem to have.
Posted 3/27/2015 1:16 PM (GMT 0)
Thanks very much for sharing. It definitely is a miserable problem. Things only started getting really bad for me after my gallbladder removal - not sure if there's a connection, or perhaps it's just a coincidence. But it's at the point now where I'm having frequent issues in spite of medicating with Zantac and other antacids.

I got the same response from my doctors (i.e., live with it) after several tests, including three endoscopes, manometry motility study, barium swallow/videofluoroscopy, and upper GI. My gastroenterologist categorized my dysphagia as "mild", even though I had been to the ER twice with food stuck and sat in the lobby holding a cup in my hand because I couldn't swallow my own saliva - lol! When I asked him about TIF, he wasn't familiar with it and would need to get back to me.

I went to another GI doc and he noticed a stricture that needed to be dilated. Wow...after three endoscopes, the other guy didn't see that? Went to an ENT and he said "oh yeah, you have LPR, which would explain the swallowing difficulty". But then he did an otolaryngoscopy and found that while there was inflammation, he didn't see anything worth worrying about. Meanwhile, I was still having trouble eating and had moved from my bed to sleeping upright on the couch.

Anyway, it's probably apparent that I'm a little burned out with most of the medical community :)

I'm really glad to hear that you've had good results with TIF. I also joined a group on Facebook ("TIF Procedure for Acid Reflux GERD") where a few members had it done with success. This is encouraging, as there's not a lot of data out there on this procedure and many of the earlier stories (circa 2008-10) were negative for the most part. I think they've come a long way with Esophyx and it seems like a good option these days.

If you don't mind, I just have a few additional questions:

1) Did you have swallowing issues prior to TIF, or what were your main symptoms?

2) How long did recovery take overall? Did you lose a lot of weight due to the diet restrictions?

3) Did they give you any idea of the long-term durability of the procedure? Is it expected to last decades?

Thanks again for your time and information :)
Posted 3/27/2015 2:15 PM (GMT 0)
I can understand that you are frustrated with the medical community. It was the same for me.

1) No, I did not have swallowing issues. The doctor had me do a swallowing test (barium I think) before the TIF. I had a frequent pain under my sternum, dry throat, bad taste in my mouth, and often had an anxious feeling that was worse after eating or laying down. All that is gone after my TIF.
2) I did not do much for 4 or 5 days. My throat was sore but I did walk a half mile on day 3 and increased the distance each day. After a week I was back to my usual routine but the diet the first two weeks did not give my much energy. I could not lift over 15 pounds (I think.) I lost 20 pounds on the restricted diet but gained it back in 6 months.
3) No, they did not give me any long-term durability of the TIF.

The pH test is scored on the Demeester scale and was done without any meds for acid. My score before the TIF was 28, I believe anything over 20 is considered severe. I had the pH test done after my TIF and my score was 5.8 which is normal. I also had my gall bladder removed before my TIF but my reflux was not worse after the gall bladder was removed. The heart burn center at my local hospital was where I got the best treatment. Good luck to you and let me know what you decide.
Posted 3/27/2015 5:53 PM (GMT 0)
I appreciate the extra info, thanks. Your change in Demeester score is very good. I hope to have that kind of result with any procedure I ultimately decide on. TIF looks like the best bet for me so far and my surgeon is proceeding on that assumption, unless they see something about my hiatal hernia that they don't like. It's between 2-3cm and they said it should be something they can repair, but they're planning to get more info on that before moving forward.

My appointment for the pH test is on April 24th, but I put in a request to have it moved up, if possible. Will post additional details here as this unfolds - hoping for the best :)

Have a great weekend!
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