Reflux Treatment (TIF) Reflux GERD

Gastroesophageal reflux disease occurs when the lower esophageal sphincter spontaneously opens or does not close properly (basically dysfunction of the muscle ring between the esophagus and stomach) and stomach contents rise into the esophagus causing irritation (such as in the case of diaphragmatic hernia), acid reflux, heartburn and other serious conditions including risk of cancer disease in the long term.
The incidence of reflux disease has risen in direct proportion to the obesity epidemic, and now affects about 10% of Israelis on a daily basis. Reflux is usually treated with acid-reducing drugs, which help relieve symptoms but do not cure the disease. It is also possible to alleviate the symptoms of reflux through changes in diet and lifestyle.

Historically, major surgery called fundoplication has been recommended for patients who have not responded to medications, but surgery involves many complications and is performed only in severe cases.

Endoscopic treatments for reflux disease, include minimally invasive techniques that fill the gap between pharmacological medical treatment and surgical surgery.

Endoscopic treatment may not only improve symptoms but in many cases take the patient off regular drug therapy altogether.

Endoscopic treatments are based on reducing the diameter of the passage between the esophagus and the stomach by tightening, with the help of the use of a special device that uses special pins or sutures.
A second approach is an electrical burn to the lower esophageal sphincter or radiofrequency energy supply for example by a device Stretta which is available in the country.

In early 2023, advanced endoscopic equipment arrived in Israel (TIF), which helps us to respond to a wide population suffering from reflux (a demonstration of the technology can be viewed in the attached video at the top of the page).
‍

What is the cause of reflux?

Reflux means “flow back” or “return”.
Gastroesophageal reflux is a condition in which what is in the stomach returns to the esophagus.

In normal digestion, the lower sphincter of the esophagus opens to allow food to enter the stomach. It is then closed to prevent food and acidic gastric juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the lower sphincter of the esophagus is weak or relaxes when it should not occur.

This condition allows the contents of the stomach to flow up into the esophagus.
‍

Risk factors for reflux

More than a quarter of the population in Israel suffers from heartburn at least once a month, and about 5% of adults experience heartburn daily - including many women during pregnancy.
Recent studies also suggest thatGastroesophageal reflux disease (GERD) More common in infants and children than was commonly thought before.
In them, it may manifest itself in repeated vomiting, coughing and various respiratory problems.

One of the possible causes of reflux is Diaphragmatic hernia.
In this position, the upper part of the stomach passes through a small opening in the diaphragm - the muscle that separates the chest cavity from the abdominal cavity.
Recent studies show that this opening helps support the lower end of the esophagus, so when a hernia develops, it may weaken the action of the lower esophageal sphincter and increase the risk of reflux.

It is important to highlight: Not everyone who suffers from a diaphragmatic hernia will experience heartburn or reflux. However, in some cases the hernia allows the contents of the stomach to rise more easily into the esophagus.
Factors such as coughing, vomiting, physical exertion or increased intra-abdominal pressure can worsen the condition and lead to the development of a diaphragmatic hernia.

Diaphragmatic hernia It is relatively common in people over 50 years of age, but it may also occur at a younger age. In most cases, it is an accidental finding that does not cause symptoms and does not require treatment. At the same time, medical treatment becomes necessary when the hernia is accompanied by significant reflux, inflammation of the esophagus, or when there is a danger of a rare complication such as suffocation or deformation in a way that cuts off or impairs the blood supply to the area, requiring immediate treatment.

‍

‍A number of other things can increase the likelihood that you will have reflux

OVERWEIGHT OR OBESITY PREGNANCY DELAYED EMPTYING OF THE STOMACH, CONNECTIVE TISSUE DISEASES SUCH AS RHEUMATOID ARTHRITIS, SCLERODERMA OR LUPUS CHOICES IN DIET AND LIFESTYLE CAN WORSEN ACID REFLUX IF YOU ALREADY HAVE IT: SMOKING CERTAIN FOODS AND DRINKS, INCLUDING CHOCOLATE AND FATTY OR FRIED FOODS, COFFEE AND ALCOHOL EATING LARGE MEALS BEFORE BED, Certain medications, including aspirin.

The most common symptom of reflux is heartburn. It usually feels like a burning pain in your chest that starts behind your sternum and moves upward to your neck and throat. Many people say that it feels as if the food comes back into the mouth and leaves an acidic or bitter taste.

The burning, pressure, or pain of heartburn can last up to two hours. Often the burning sensation can be worse after eating. Lying down or bending over can also cause heartburn.
Many people feel better if they stand upright or take an acid repellent that cleans acid out of the esophagus.

Chest pain - heartburn or heart disease?

It's sometimes hard to tell if the pain is caused by heartburn or heart disease, but there are some signs that may help.
In heart disease, pain tends to worsen during exercise and improve at rest.
In contrast, pain originating from heartburn is not usually affected by physical activity.
‍

It is important to know: The two cannot be definitively distinguished.
Therefore, in any situation of pain in the chest it is necessary to immediately seek medical help!
‍

Other symptoms of heartburn or reflux (GERD):

• Nausea.
• Bad breath.
• Difficulty swallowing or feeling of a lump in the throat.
• Vomiting.
• Erosion of tooth enamel.
• Difficulty breathing.

When the reflux appears mainly at night, there may also be:

• Chronic or persistent cough.
• Inflammation of the throat.
• NEW ASTHMA ATTACKS OR WORSENING OF EXISTING ASTHMA.
• Sleep disorders.

Innovative treatment for reflux!
Transoral Incisionless Fundoplication (TIF)

Gastroesophageal reflux disease is a very common condition among the large population. Symptoms of heartburn or regurgitation (an increase in stomach contents and esophagus and pharynx) have been reported in 25% of patients in developed countries every year.
Although drug therapy gives a solution to a significant proportion of patients, a significant number of people (ranging from 10% to 40% of patients) may fail to achieve a complete resolution of the symptoms.

Given the significant impact of symptomatic reflux disease on quality of life, alongside the high costs and increasing awareness of possible adverse effects from long-term treatment with pills.

Now after years of waiting, we are proud to be at the forefront of medical technology innovation and bring the gospel to the patients in Israel Transoral Incisionless Fundoplication (TIF).

TIF IS AN INVASIVE, ENDOSCOPIC, SEXUAL PROCEDURE FOR RESTORING THE NATURAL SHAPE AND EFFICIENCY OF THE ESOPHAGEAL VALVE AND THEREBY STOPPING REFLUX.
process TIF Considered much safer compared to surgery, with a faster recovery time for the patients, and all with amazing clinical results.

Multiple international studies have shown that procedure TIF Successfully performed in up to 99% of patients, with only 2% experiencing problems during or after the procedure, such as tearing or internal bleeding. For a large number of patients, TIF provides significant relief of symptoms of reflux and improvement in quality of life. Most patients (91%) also experience a reduction in diaphragmatic hernia and many (89%) are able to stop taking antacids (PPI).
‍
The relief of symptoms after TIF Usually lasts between eight and 10 years, which is similar to relief in most cases of surgical treatment. When the reflux symptoms recur.

If we compare the numbers with Israel, we can say that about 250 to 500 thousand people are potential candidates for endoscopic treatment TIF Reflux, treatment of which can significantly improve the quality of life, and reward from regular drug therapy.

‍

Recommended foods for reflux sufferers in general

* The information provided on the website regarding recommended foods is for teenagers and is not a substitute for consultation with a doctor/clinical dietitian.

It can be said that for most patients suffering from reflux - it is recommended to eat the following foods:
‍
Low-acid fruits: These include bananas, melon and apples.

Vegetables: leafy greens, broccoli and potatoes.

Lean proteins: chicken, fish and tofu.

Whole grains: oatmeal, quinoa and whole wheat bread.

Non-fat or low-fat dairy products: milk, yogurt and cheese.

Healthy fats: avocado, olive oil and nuts.

It is also important for people with GERD REFLUX Avoid spicy, fatty or acidic foods, as well as carbonated drinks and caffeine. Eating smaller and more frequent meals may prove to be beneficial, avoiding eating near bedtime.

It is important to note that each person is different and what may trigger symptoms in one person may not trigger anything in another person.
It is recommended to keep a food diary to keep track of the foods that aggravate your symptoms. If you are not sure which foods may trigger the symptoms of GERD REFLUX You are advised to consult a healthcare professional.