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Here we try and present interesting articles that pertain to conditions like reflux, paraesophageal hernias achalasia,  that hopefully can give you a better understanding of your options.

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Popular heartburn drugs linked to higher early death risk

July 5th 2017

Millions of U.S. residents take proton pump inhibitors which are widely prescribed to treat heartburn, ulcers and other gastrointestinal problems. Now, a new study shows that long-term use of the popular drugs carries an increased risk of death.

Robotic Reoperative Anti-reflux Surgery: Low Perioperative Morbidity and High Symptom Resolution.

July 2018

Our group published data on re-operative surgery and showed high success rates and avoided open surgery when patients presented after a failed initial surgery. Most patients underwent their first procedure elsewhere and had excellent outcomes and low complication rates.

Heller Myotomy Versus Endoscopic Myotomy reflux outcomes

May 2017

Endoscopic POEM myotomy associated with a significantly higher reflux rate (47%) versus laparoscopic heller myotomy (11%) as well as longer hospitalization going against a less invasive approach.

August 26, 2018

Avoiding Open Surgery with Robotics

Surgical intervention is the cornerstone to successful reflux and achalasia. However, if we need to go back without expertise this can be very difficult.

 

Our group published our findings on successful re-operative surgery using robotics for reflux and achalasia.

We show low complication rates and no conversion to open with high success rates even when we have to operate on patients.

September 17, 2015

LINX reflux procedure with promising 5 year results for reflux

Magnetic sphincter augmentation with the LINX Reflux Management System was shown to provide safe and sustained control of GERD symptoms at 5 years in a recent study.

The LINX (magnetic sphincter augmentation, Torax) procedure is an alternative to fundoplication that entails a minimally invasive laparoscopic implantation of a small device made of interlinked titanium beads with magnetic cores, which prevents reflux by augmenting the esophageal sphincter’s barrier function, according to a press release.

May 31, 2017

Surgery for achalasia has dramatically less reflux than endoscopic solutions

Study in a peer reviewed journal compared outcomes of the surgical repair for achalasia (Heller Myotomy) and compared this to the endoscopic repair (POEM).

With nearly 8000 patients both groups showed similar results on improvement of symptoms of difficulty swallowing 91% versus 93%. However, the study showed that patients that underwent endoscopic repair (POEM) were 1.7 times more likely to have reflux symptoms and 9.3 times more likely to have esophagitis on endoscopy. 

Therefore rates of reflux are 11% for surgical heller versus 48% for POEM. This should be strongly discussed with patients so they are aware they are not trading one disease for another.

Overall, length of stay was also longer for the POEM

July 05, 2017

Millions of U.S. residents take proton pump inhibitors which are widely prescribed to treat heartburn, ulcers and other gastrointestinal problems. Now, a new study shows that long-term use of the popular drugs carries an increased risk of death.

Therefore, when taking these medications patients and doctors should ensure that they are being administered appropriately and giving patients options on appropriate therapy and alternatives prior to initiating long-term therapy.

The issue also arises that with the easy access to these medications as they are over the counter appropriate tracking of patient usage is hard to determine.

May 24, 2017

Drugs for reflux disease in infants may come with unintended consequences

Babies throw up, a lot. But caution is needed before turning to a drug to help. Infants prescribed proton-pump inhibitors to treat reflux disease broke more bones in the next several years than infants not given the drug.

Given the routine use of these medications in the newly born population that have severe spitting and the lack of objective testing to assist in the diagnosis of these patients caution must be advised on their initiation. Especially due to the unclear long term effects.

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