Many people experience a burning sensation in their chest or throat, known as heartburn or acid indigestion, from time to time, particularly after a large meal or a spicy dish. However, if you are experiencing heartburn twice a week or more, you may have gastroesophageal reflux disease, or GERD, according to the National Institutes of Health (NIH).
GERD affects millions of people in the United States alone, and if left untreated, can lead to serious complications such as inflammation and ulcers in the esophagus, and eventually even cancer.
Lifestyle changes, such as weight loss, smoking cessation and avoidance of certain foods, are usually the first line of defense against GERD. Medications are also available to relieve symptoms. But for some, medicine and lifestyle changes fail to make a difference.
For a number of years, John Lipham, M.D., assistant professor of surgery, and Tom DeMeester, M.D., professor of surgery at the Keck School of Medicine of USC, have been working on alternative ways to treat GERD.
Most recently, they have been involved in testing a new device to treat GERD, which is now in the second phase of clinical trials at the Keck School of USC. The School also is serving as a training center for other institutions to learn the procedure.
“Reflux is known to cause adenocarcinoma (cancer) of the esophagus,” says Lipham. “Over the last 25 years, we have seen somewhere between a 400 and 600 percent increase in reflux-caused esophageal cancer.”
Traditionally, chronic reflux disease that cannot be controlled by medication is treated using a surgical procedure called a Nissen fundoplication, which involves recreating a sphincter—a muscle that constricts and relaxes as required for normal physiological functioning—at the end of the esophagus. According to Lipham, USC has an approximately 90 percent success rate with entirely stopping the reflux.
“Although the success rates of the surgery are good, there are problems associated with this procedure,” says Lipham. “One of the biggest problems is that it prevents the ability to belch or vomit and patients experience severe bloating and gas problems.”
But with new technology called the Linx Reflux Management System, now being used in the department of surgery at the Keck School of Medicine, the treatment of reflux disease has improved.
The Linx device is like a bracelet made up of magnetic beads implanted around the end of the esophagus where the lower esophageal sphincter is located. The lower esophageal sphincter is the valve that prevents reflux, and GERD develops when this valve is weakened.
The new device is designed to augment the native sphincter and return it to a competent valve. The magnetic beads open with a given pressure, allowing patients to belch, vomit and swallow normally. By allowing patients to belch normally, the device allows air to escape from the stomach, preventing gas and bloating issues.
“This is a much simpler procedure,” says Lipham. “There is much less surgery involved to implant the device, making patient recovery quicker.”
In fact, the procedure uses a minimally invasive surgical technique that involves small incisions in the abdominal wall to access the area around the esophagus where the device is implanted. The procedure is typically performed in less than an hour.
The Keck School was one of only two institutions in the United States to participate in the first phase of the Linx Reflux Management System clinical trial. According to Lipham, the trial showed excellent results with an approximate 75 percent success rate.
If you have been diagnosed with GERD, you may be eligible to participate in the second phase of the trial, which has expanded to sites across the United States and is currently recruiting participants. Find more information on the study.
If you think you may have GERD, talk to your doctor about your symptoms. Heartburn and regurgitation are the key indicators of GERD, but symptoms can also include difficulty swallowing, a sore or hoarse throat, cough and upper abdominal pain. A diagnosis of GERD is often confirmed through a trial of medications or through tests that look for abnormalities in the esophagus.
For more information on GERD in general, visit the American College of Gastroenterology website, or the American Gastroenterological Association website.