Is GERD giving you grief? New TIF procedure could be the answer

Ivan Harnden, MD is a board-certified gastroenterologist. He serves as the System Chief of Gastroenterology at Inova. Dr. Harnden focuses on a collaborative approach and strategic vision aimed at enhancing patient outcomes and delivering outstanding GI care to the community served by Inova.

There’s a reason that drugstores have an entire aisle devoted to antacids. Heartburn is extremely common. For about 1 in 5 people, that heartburn is caused by gastroesophageal reflux disease, or GERD. GERD is a chronic form of acid reflux that causes heartburn, cough and sore throat. Over time, it can damage the esophagus, irritate the lungs or cause other serious problems.

Luckily, many people with GERD find relief by modifying their diets and taking acid-reducing medications (both over-the-counter and prescription). But some people have reservations about taking those drugs every day for years on end. Others still experience symptoms, despite medications and diet changes.

For those patients, a new procedure called TIF could be a great option for long-term relief.

TIF: Tightening Leaky Valve

GERD can occur for a variety of reasons. One of the most common causes is a leaky valve at the bottom of the esophagus, which allows stomach acid to back up where it shouldn’t. Another cause is a hiatal hernia, which occurs when a small part of the stomach pushes up through the diaphragm.

In many cases, TIF can solve these problems. Short for transoral incisionless fundoplication, the procedure allows us to tighten the leaky valve — without a surgical incision. Instead, we pass an instrument called an endoscope through the patient’s mouth and into the stomach. Using the device, we use sutures (stitches) to tighten and lengthen the valve.

TIF is very safe, and most patients go home the same day. They have to follow a modified diet while they heal over the next few weeks. But as the valve heals, it becomes nice and strong. More than 80% of patients can stop taking acid-reducing medications after TIF.

Surgical Treatments for GERD

Other procedures have been available to treat GERD before now. While they’re safe and effective overall, they do have some downsides.

• Fundoplication tightens the valve in a similar way to TIF, but it requires small incisions in the abdomen. Patients who have this procedure often experience gas and bloating, because the valve can be so tight that they aren’t able to belch.
• The LINX procedure implants a string of metal beads to tighten the muscle at the bottom of the esophagus. But some patients experience a feeling of difficulty swallowing.

For the right patients, TIF is a promising alternative that avoids these complications, requires no incisions and leaves no scars. Still, like all surgical procedures, there are side effects to TIF too, so it’s important to talk to your doctor about the right treatment for you.

Who Is a Candidate for the TIF Procedure?

For a lot of people, acid reducers do a good job of controlling symptoms of GERD. But you might want to consider a procedure like TIF if you:

• Still have symptoms despite taking medication and/or changing your diet.
• Require higher and higher doses of acid-reducing medications to control your symptoms.
• Can control heartburn with medication, but continue to have other problems such as cough or asthma-like symptoms (which can be caused by the regurgitation of stomach contents into the lungs).
• Do not want to be committed to using long-term acid-reducing medications.

Some people aren’t able to have the TIF procedure because of their anatomy. We do some testing ahead of the procedure to determine which patients are good candidates. TIF is a good option to correct GERD in people with small hiatal hernias, for example. But people with large hernias often need to have the hernia repaired through traditional surgery, rather than TIF.

TIF at Inova

The TIF procedure is a cutting-edge treatment for GERD, and its popularity is growing quickly as happy patients spread the word about their success with the treatment. Inova is still one of the only providers in the region that offers TIF, both at Inova Fair Oaks Hospital and Inova Fairfax Hospital. Other treatment options for digestive health are also available at Inova Alexandria Hospital through the Inova Heartburn Treatment Center.  It’s all part of our commitment to providing the latest, most effective treatments for digestive disorders.

To make an appointment with a doctor trained in the TIF procedure, contact:

• Richard Allen Blosser, MD at 703-810-3591
• Ivan Peter Harnden, MD at 703-783-5417
• Iris Lee, MD at 703-783-5417

Contact us online!

Use our online form to ask a question or request an appointment: Heartburn Patient Contact Form