Next, I present all the information I've collected to one of our spe-
cialists. Our goal is to do everything as a one-stop shop, so a couple of
days later, when we schedule a consultation, we can also have any
needed testing done at the same time. That way, people don't have to
take a lot of time off from work. They can get everything done and
follow-up with a physician a couple of days later after their individual-
ized plan is in place.
Time for incision-free TIF
For patients who have chronic reflux and who don't respond to
lifestyle changes or medication, we've had tremendous success, pri-
marily with the endoscopic TIF (transoral incisionless fundoplica-
tion) procedure. Similar to Nissen fundoplication, TIF alleviates
GERD symptoms by wrapping a portion of the stomach around the
esophagus to restore the esophageal valve. But unlike traditional fun-
doplication, the TIF procedure is performed through the mouth
rather than through laparoscopy or open abdominal incisions. We did
our first few TIFs in 2016, then almost 40 in 2017 and well over 50 in
2018.
Among the anti-reflux procedures we do, TIF offers immediate
results. We usually do it as an outpatient procedure, and many of our
patients are off their medications within 2 or 3 months. They can
enjoy the foods they couldn't eat previously, without any ill effects —
even such trigger foods as chili, wine, chocolate and coffee.
To help document our success, I give patients a quality-of-life survey
the day of the procedure and the same survey again after 2 months.
The questions cover severity of symptoms, whether their reflux keeps
them up at night, how often they have regurgitation and so forth.
What we find is that on a 0 to 50 scale, with zero being the score that
indicates no problems at all, the average before surgery is around 25;
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