Dr. Michael Ujiki (NorthShore)
Great question, Rick. Surgical technology has evolved so that surgeries that used to require a 20 centimeter incision can now be done through natural orifices such as the mouth. This results in no incision, no scar and no pain associated with that incision. Other advantages include avoiding incisional hernias.

Dr. Michael Ujiki (NorthShore)
Excellent question. For a young person such as yourself, you should hear what options are available which include the TIF procedure. Otherwise, you will be committing yourself to antacid medications for the next 40 to 60 years. We have recently learned that though these medications were previously considered very safe, they can result in problems such as osteoporosis, infections in the GI tract (like C diff colitis) and interference with other medications you may need for your heart such as Plavix. So in general, the medications are well tolerated, someone at your age should hear about options from an experienced GERD or reflux physician.

Dr. Michael Ujiki (NorthShore)
Thank you, Monica. I applaud you for a healthy lifestyle and that's a first step toward attacking reflux. Unfortunately, we know that even with maximizing lifestyle changes, reflux can persist. If your medications are not consistently effective, you should speak to an experienced reflux physician regarding options such as the TIF procedure. Candidates for this procedure include those that have proven reflux and are not responsive to medications or do not want to be on medications long term. In addition, no mechanical contra-indications to the procedure such as a large hiatal hernia (greater than 3 centimeters) can be present. For those of you who do not know what a hiatal hernia is, it is when the junction between the esophagus and stomach lie in the chest rather than in the abdomen where it should normally lie.

Dr. Michael Ujiki (NorthShore)
Different foods can cause heartburn for different people. But in general, acidic foods such as tomatoes, oranges and spicy foods. Other foods such as caffeine, alcohol, even peppermint or chocolate can relax the valve at the bottom of the esophagus and result in reflux and heartburn. We, thus, recommend to patients with reflux that they avoid these foods. Tobacco can also relax the valve and should be avoided.

Dr. Michael Ujiki (NorthShore)
The TIF procedure at two years has shown to resolve heartburn in over 90 percent of patients. It also results in complete cure of reflux in 70 to 80 percent of patients being off of antacids. The nice thing about this procedure is that it is incisionless so very little pain is experienced. In addition, people can get back to their normal everyday activities and work, almost right away - within a day or two. Most importantly, it is a very safe procedure.

Dr. Michael Ujiki (NorthShore)
With the use of a standard endoscope which is a long, flexible tube with a camera on its end, we enter through the mouth and down the esophagus where we then rebuild the valve at the end of the esophagus and restore its natural anatomy. This results in a barrier to stomach acid. If you come to one of us who performs the TIF procedure, we can show you an animation of how the procedure works. The technology is very impressive.

Dr. Michael Ujiki (NorthShore)
That's a great question. This concern is a very common occurrence. Asthma and reflux have been linked for a long time and, unfortunately, they cycle off each other: Reflux makes asthma worse and asthma, in turn, can make reflux worse. PPIs make the refluxate (or stomach juice) less acidic but does not stop it from entering into the lungs by way of the esophagus. We, therefore, feel strongly that the mechanical barrier (the valve) at the end of the esophagus be restored to its natural anatomy. Whether it be TIF or a laparoscopic procedure, this may be more effective than just medications alone in the treatment of asthma associated with reflux. You should see an experienced reflux doctor regarding this concern.

Dr. Michael Ujiki (NorthShore)
Alcohol has been found to relax the valve at the end of the esophagus, resulting in reflux that can cause heartburn. We, therefore, recommend that people who suffer bad reflux avoid alcohol.

Dr. Michael Ujiki (NorthShore)
Currently, there are several effective medications available. Some are over the counter such as H2 antagonists (i.e., Pepcid), proton-pump inhibitors (i.e., Prilosec), and others require prescription.

Dr. Michael Ujiki (NorthShore)
Very good question because we know that symptoms do not correlate well with the amount of injury to the esophagus. You should definitely let your physician know if you have difficulty swallowing food, for example. Otherwise, I applaud you for the lifestyle changes you made, and often times, that's all that is required to help reflux disease. Intermittent use of antacids is probably the best indication for those medications. Again, seek the advice of your physician if this is more than just heartburn or if it just concerns you.

Dr. Michael Ujiki (NorthShore)
Congratulations on having a great gastroesophageal valve. If you are not having problems, then you don't have to avoid those foods.