Finding Relief for GERD
The whole care experience was just superb. And the minute I had my surgery, I was able to lie flat again, which has been great. I feel like I’m back to where I was 20 years ago.” - Ralph Thomas
Many of us have become familiar with the symptoms of heartburn and regurgitation—the burning sensation that moves from our chest up into our throats, and the bitter taste that's often left in the back of our mouths.
In fact, it's estimated that more than 60 million Americans suffer symptoms of acid reflux each month. Most of the time, over-the-counter medications and lifestyle changes can provide relief. But for a subset of this population (roughly 15 million), the symptoms become chronic, happening on a daily basis.
"That's when the person is suffering from significant gastroesophageal reflux disease (GERD)," explains Dartmouth-Hitchcock (D-H) surgeon Ted Trus, MD, who specializes in treating the disorder. "GERD occurs when the lower esophageal sphincter (LES), the closure valve between the esophagus and stomach, is incompetent and allows stomach acid to leak back into the esophagus."
Coping with GERD
That was the case with Ralph Thomas of Sunderland, Vermont. "About four or five years ago, I graduated from over-the-counter antacids to Nexium," recalls Thomas. "I started with one a day and that worked for a while. But the symptoms kept getting worse and my doctor upped me to two a day, one in the morning and one at night."
The increase in medication provided only temporary relief. "I tried to avoid dropping things from my diet, like wine and late-night foods, but I had to do it as time went on," says Thomas, who was also forced to sleep propped up in bed for over two years.
"I work as a musician for the Vermont Symphony Orchestra, so being able to eat after rehearsals in the evening has been important to me," he says. "And because I'm a wind player as well as a string player, I became more and more concerned that the acid would eventually cause damage to the back of my throat." Left unchecked, GERD can sometimes cause serious complications, such as ulcers or narrowing of the esophagus, and may even increase the risk of developing cancer of the esophagus.
New LINX® Procedure
Thomas discussed his options and the possibility of having surgery with his primary care physician. "I'd gotten a letter from my prescription insurance company, cautioning me about the potential risks of taking too much Nexium," he says. "My doctor told me he knew somebody at D-H who was an expert on new treatments for GERD."
A visit with Dr. Trus, which included a number of tests, confirmed that Thomas needed surgery. One option was the Nissen fundoplication procedure, where the surgeon takes a portion of the stomach and wraps it around the esophagus to enhance the tone and function of the lower esophageal sphincter.
Though a well-established and effective procedure, Thomas thought, "That sounds pretty invasive, especially for someone like me who works the whole diaphragm area pretty hard," he says.
Instead, in November of 2013, he opted to be the first patient at D-H (and in Northern New England) to receive the LINX®, a new device that had recently been approved by the Food and Drug Administration. "The device is a small, flexible band made up of earth magnet beads," explains Trus. "We implant it around the esophagus just above the stomach laparoscopically, so it's a less invasive procedure. The magnetic attraction between the beads helps keep the lower esophageal sphincter closed, reinforcing the body's natural barrier to reflux."
Thomas had the procedure done in the morning at D-H and was ready to go home by mid-afternoon. "I would have been released even earlier, except I also had an umbilical hernia repaired, which I knew beforehand I needed to have done," he says. "The whole care experience was just superb. And the minute I had my surgery, I was able to lie flat again, which has been great. I feel like I'm back to where I was 20 years ago."
Certain conditions or complications may prevent some patients from meeting the criteria for the LINX® procedure. "But there are a large number of patients like Ralph, who've had reflux for years and are dependent on daily medication, that this would be an appropriate substitute for," says Trus. "We're excited to be able to offer this new option to patients."
One of Thomas' favorite things about the treatment is, unlike other procedures like fundoplication, there are no post-surgery restrictions on a patient's diet. "I was actually able to have a cheeseburger on my way home, which was awesome," he says, laughing. "That was something I hadn't been able to enjoy in a very long time."