When GERD is the Word – What to Consider when Diagnosed with Gastroesophageal Reflux Disease

Many people experience acid reflux from time to time – that feeling commonly thought of as heartburn or acid indigestion. Gastroesophageal Reflux Disease (GERD) is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week. While most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications, some people with GERD may need stronger medications or surgery to ease symptoms.

Make an appointment with your doctor if you:

  • Experience severe or frequent GERD symptoms
  • Take over-the-counter medications for heartburn more than twice a week

When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.

If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.

Conditions that can increase your risk of GERD include:

  • Obesity
  • Bulging of the top of the stomach up into the diaphragm (hiatal hernia)
  • Pregnancy
  • Connective tissue disorders, such as scleroderma
  • Delayed stomach emptying

Factors that can aggravate acid reflux include:

  • Smoking
  • Eating large meals or eating late at night
  • Eating certain foods (triggers) such as fatty or fried foods
  • Drinking certain beverages, such as alcohol or coffee
  • Taking certain medications, such as aspirin

Your doctor is likely to recommend that you first try lifestyle modifications and over-the-counter medications. If you don’t experience relief within a few weeks, your doctor might recommend prescription medication or surgery.

The options include:

  • Antacids that neutralize stomach acid 
  • Medications to reduce acid production known as H-2-receptor blockers
  • Medications that block acid production and heal the esophagus known as proton pump inhibitors
  • Medication that helps strengthen the lower esophageal sphincter. 

GERD can usually be controlled with lifestyle changes and medication, but if these don’t help or you wish to avoid long-term medication use, consider the revolutionary LINX device. This device consists of a ring of tiny magnetic beads which is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the junction closed to refluxing acid but weak enough to allow food to pass through when swallowing. The LINX device can be implanted using minimally invasive surgery.

As the first LINX-trained surgeons in Las Vegas and as the first digestive institute in the area to offer the only FDA-approved treatment for GERD, Dr. Shawn Tsuda and Dr. Heidi Ryan at VIPSurg are ready to help you fight back against gastroesophageal reflux disease. Call  702-487-6000 to schedule an appointment. 

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GERD and Hiatal Hernia: Could LINX® Reflux Management System Be Right for You?

Acid reflux, heartburn, and indigestion are all common symptoms of gastroesophageal reflux disease or GERD. This common problem afflicts over 20 million people every day here in the United States.

A hiatal hernia is when the stomach slips up into the chest. Hiatal hernias can worsen acid reflux because the typical sphincter mechanism in the lower esophagus is dysfunctional, and there is a mechanical disturbance of the natural flow of solid foods and liquids. Pregnancy, obesity, coughing, or constipation increase intra-abdominal pressure, which can worsen the symptoms of reflux and worsen a hiatal hernia.

Generally, hiatal hernias occur more often for patients who are overweight, women, and over 50 years old. Hiatal hernias can be diagnosed with upper endoscopy (EGD), an esophagram or upper gastrointestinal (UGI) series.

The LINX® Reflux Management System is a small and flexible band of interlined titanium beads with magnetic cores. To select the right size, the esophagus is measured with a specialized tool for all patients undergoing placement of a LINX device. First, a necklace-like tool is placed around the lower esophagus at the level of the lower esophageal sphincter (LES) to get the best fit for the LINX device. The measurement tool is then removed, and the LINX device is implanted, making sure the ends of the band are aligned and securely linked.

Magnetic attraction between the beads helps the lower sphincter resist opening to gastric pressures, preventing reflux of the acidic content in the stomach into the esophagus. The device is designed so that normal swallowing pressures temporarily break the magnetic bond, allowing food and liquid to pass normally into the stomach. Due to the magnetic attraction, the device will assist in closing the lower sphincter immediately after swallowing, augmenting the lower esophageal sphincter and restoring the body’s natural barrier to reflux.

If you suffer from GERD and would like to decrease, or in some cases, completely stop taking medication for this problem, the LINX® Reflux Management System could be the perfect solution for you. Schedule an appointment at VIPSurg to learn more.

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LINX: A Small Device Getting Big Results

Most of us experience heartburn or indigestion once in a while. Sometimes it comes from overeating; other times it happens from eating or drinking something acidic or spicy which irritates the digestive tract. Frequent heartburn, however, can be a sign of a more serious disorder known as gastroesophageal reflux disease (GERD). GERD is a digestive disorder that affects the lower esophageal sphincter (LES), which is the ring of muscle between the esophagus and stomach. While GERD can often be controlled with diet changes and/or medication, more severe cases require surgery. The LINX device and procedure is changing the lives of people who suffer from chronic GERD.

Doctors believe that some people suffer from GERD due to a condition called hiatal hernia. A hiatal hernia occurs when the upper part of the stomach bulges through the diaphragm muscle which separates the abdomen and chest.

The diaphragm has a small opening (hiatus) through which the esophagus passes before connecting to the stomach. With a hiatal hernia, the stomach pushes up through that opening and into the chest.

A small hiatal hernia usually doesn’t cause problems. You might never even know you have one unless your doctor discovers it when checking for another condition. A large hiatal hernia, however, can allow food and acid to back up into the esophagus, leading to heartburn.

You might think that although heartburn can be very uncomfortable and even quite painful, surgery seems like an aggressive treatment for a common condition. Unfortunately, the long-term effects of GERD can be increasingly serious.

Left untreated, GERD can cause:

  • Esophagitis – inflammation of the esophagus.
  • Esophageal stricture – the esophagus becomes narrow, making it difficult to swallow.
  • Barrett’s esophagus – the cells lining the esophagus change into cells similar to the lining of the intestine. This can develop into cancer.
  • Respiratory problems – it is possible to breathe stomach acid into the lungs, which can cause a range of problems including chest congestion, hoarseness, asthma, laryngitis, and pneumonia.

Fortunately, when changes in lifestyle, diet, and medication don’t help, there is a Actual size.Actual benefits are immeasurable.minimally invasive procedure that is having life-changing results for GERD patients. It’s called LINX. This simple ring of titanium magnets is a small device that brings big results.

LINX is easy to understand and love because it is simple. The beauty of this quarter-sized device is that it does exactly what your failing LES is supposed to do — prevent stomach acid from entering your esophagus.

Why is LINX so great?

  • Unlike other procedures to treat reflux, LINX is implanted around the outside of the LES and requires no alteration to the stomach.
  • LINX preserves normal physiological function so you can belch or vomit as needed. The titanium beads open and close to let food down, and if it needs to come up, it can.
  • Designed for a lifetime. LINX is constructed of titanium, and the permanent magnets mean LINX will be working for you for the long haul.
  • Designed for everyday life. The device will not affect airport security. And you can still have an MRI.
  • LINX is designed to start working the moment the device is implanted.

Are you ready to take back control of your digestive health? LINX is intended for patients diagnosed with Gastroesophageal Reflux Disease (GERD), and who are seeking an alternative to continuous acid suppression therapy. Are you concerned with a lifetime of medication, pharmacy visits, and potential side effects? If this sounds like you, and you live in the Las Vegas area, schedule a consultation at VIP Surg. LINX can change your life.

 

 

 

 

Metabolic Syndrome: The New Silent Killer

For decades, American waistlines have been expanding, and there is increasing cause for alarm. Experts are saying metabolic syndrome is the new “silent killer,” like hypertension in the 1970s. As it turns out, the “love handle” can be fatal.

What is Metabolic Syndrome?

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Metabolic syndrome is a cluster of metabolic disorders. When a patient presents with these conditions together, the chances for future cardiovascular disease is greater than any one factor presenting alone.

What are Metabolic Risk Factors?

Risk factors are traits, conditions, or habits that increase one’s chance of developing a disease. The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.

  • A large waistline. This also is called abdominal obesity or “having an apple shape.” Screen Shot 2017-10-24 at 11.41.55 AMExcess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
  • A high triglyceride level (or you’re on medicine to treat high triglycerides).
  • A low HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol).
  • High blood pressure (or you’re on medicine to treat high blood pressure).
  • High fasting blood sugar (or you’re on medicine to treat high blood sugar).

Your risk for heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. The risk of having metabolic syndrome is closely linked to overweight and obesity and a lack of physical activity.

Insulin resistance also may increase your risk for metabolic syndrome. Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome.

Can Metabolic Syndrome be Treated?

Metabolic syndrome is becoming more common due to a rise in obesity rates among adults, but it is possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your health care providers.

When changes in lifestyle alone do not control the conditions related to metabolic syndrome, your health practitioner may prescribe medications to control blood pressure, cholesterol, and other symptoms. Carefully following your practitioner’s instructions can help prevent many of the long-term effects of metabolic syndrome. Every step counts, and your hard work and attention to these areas will make a difference in your health.

If you live in the Las Vegas area and are looking for answers to obesity and metabolic syndrome problems, schedule a consultation with VIP Surg. Dr. Tsuda and Dr. Ryan and their team of experts can help find the right treatment for you.
 

Overcoming Genetics with Bariatric Surgery

Many of us have struggled with our weight. Whether it’s those 30 pounds of baby weight that have stubbornly hung around long after the baby was born or the 50 pounds gained after a back injury, weight gain is for many a constant struggle and a sensitive subject.

However, inactivity and poor diet are not the only causes of obesity. Research estimates that genetics determines at least 40 to 50 percent of our weight. Unfortunately, the specific genes are not well understood.

How can one overcome genetics? If everyone in your family is heavy, isn’t it a foregone conclusion that you will be heavy also? Not necessarily. Fortunately, we can level the genetics playing field with weight-loss surgery.

The most popular weight loss procedure in the United States is the laparoscopic sleeve gastrectomy. The surgery is minimally invasive, takes about an hour and requires an overnight stay in the hospital for most patients. The stomach, which regularly can hold about the volume of a football, is stapled and divided so that it is the shape and size of a banana.

Weight loss is achieved because the patient can no longer eat a large volume of food, and calories are proportionately decreased. The pylorus, the muscular valve at the outlet of the stomach, is left intact in this surgery. This also helps patients who have this procedure stay full.

Besides the effects of the procedure on restricting food volume, there is increasing evidence that the mechanisms in the brain that cause hunger are permanently modified by the sleeve gastrectomy. People state that they no longer feel hungry and no longer crave some of the high-calorie foods they used to.

Weight-loss surgery is a powerful tool in the hands of the patient, but it is not an “easyfix.” Sleeve gastrectomy requires commitment to healthy food choices and exercise on the part of the patient. The exciting news is that those struggling with obesity are not doomed to a life of aches and pains, poor health, and a miserable quality of life. There is help, and there is hope.

If you are in the Las Vegas area and are considering bariatric surgery, schedule an appointment with VIP Surg. Dr. Tsuda, Dr. Ryan, and their expert team can help find the right treatment for you.

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LINX: Treating GERD with Innovation

A hiatal hernia occurs when part of the stomach pushes through the diaphragm. The diaphragm normally has a small opening for the esophagus. This opening can become the place where part of the stomach pushes through. Small hiatal hernias often cause no symptoms, while larger ones can cause pain and heartburn, leading to gastroesophageal reflux disease, or GERD. In 2012, the Food and Drug Administration approved a new treatment device called the LINX Reflux Management System to offer a new approach to treating GERD, a disease that is increasing at a rate of 30 percent every decade.

Think of the stomach as a mixing bowl that allows food and digestive juices to combine to begin the digestive process. The stomach has a protective lining that prevents acid in the digestive juices from eating away at the stomach muscle and causing inflammation. Unfortunately, the esophagus does not have a similar protective lining. Instead it relies on the lower esophageal sphincter (LES) to act as a valve to prevent acid from refluxing from the stomach into the esophagus. In the situation of a hiatal hernia, part of the stomach pushes up through the opening allowing acid to pass into the esophagus causing symptoms may include the following:

  • heartburn
  • nausea, vomiting, or retching (dry heaves)
  • burping
  • water brash, the rapid appearance of a large amount of saliva in the mouth that is stimulated by the refluxing acid

Symptoms usually are worse after meals. These symptoms may be made worse when lying flat and may resolve with sitting up or walking.

In some patients, reflux into the lower esophagus sets off nervous reflexes that can cause a cough or even spasm of the small airways within the lungs (asthma). A few patientsanatomy-archers may reflux acid droplets into the back of their throat. This acid can be inhaled or aspirated into the lung causing coughing spasms, asthma, or repeated infections of the lung including pneumonia and bronchitis. This may occur in individuals of all ages, from infants to the elderly.

Fortunately, the innovative LINX procedure is helping with this significant health problem. This device is a series of magnets in the form of ring that is implanted around the bottom of the esophagus during a short, 40-minute laparoscopic procedure.

The ring of magnets is designed to stay closed and prevent the reflux valve from opening thereby preventing acid from the stomach move up into the esophagus. The magnets will open up the ring when people are eating to let food in much like a person’s native reflux valve.

 

Here are some things you need to know about the LINX procedure.

  • It is focused on the underlying cause of reflux disease not the side effect. Reflux disease is a result of a damaged lower esophageal sphincter (LES).
  • It is safer than the long-term use of proton pump inhibitors (PPIs). Studies have proven that reflux disease can progress even when PPI therapy has effectively eliminated GERD symptoms. LINX is effective at reducing symptoms and improving quality of life.
  • A recent study published in the New England Journal of Medicine tracked 100 patients for three years after their LINX surgery. That study found an overall decrease in stomach contents reaching the esophagus, fewer reflux symptoms, and a substantial reduction in PPI usage.
  • The side effects disappear over time in most cases. Initially, most patients experience some discomfort, but it typically dissipates over several weeks. In addition, the most commonly reported side effect is mild difficulty swallowing, which usually subsides over time.
  • The cost can be much less than a lifetime of PPI use: a 2010 study by Consumer Reports found once-a-day PPI use can range from $2,000 to $4,500 per year for brand name prescription PPIs.
  • This is minimally invasive and is performed as an out-patient procedure.
  • LINX is reversible and can be replaced.
  • Since the LINX band is placed around the LES, the device can be removed or replaced, if necessary.
  • This procedure is recommended for those with continued GERD symptoms under maximum therapy prescribed by a specialist.
  • LINX is not for everyone with advanced GERD. Today LINX is not approved for those with Barrett’s Esophagus or anyone suffering from esophageal cancer. It is important for everyone suffering from advanced stages of reflux disease to explore all available options before their disease progresses to the point where options are limited.

It is important to take your heartburn symptoms seriously because they are signals from your body that something is wrong. Since reflux disease is a progressive chronic condition, treating it early could prevent you from having to consider surgery later on.

As the first LINX trained surgeons in Las Vegas, Dr. Shawn Tsuda and Dr. Heidi Ryan at VIP SURG are ready to help you fight back against gastroesophageal reflux disease. Schedule a consultation to learn more.

 

 

The Link Between Seasonal Allergies and Reflux

While many may think of seasonal allergies happening in the spring along with blooming flowers, fall can also be a difficult time for those who are allergic. Ragweed, dust, mold, mildew, and the removal of fall crops are just some of the possible fall triggers for allergy sufferers. What many people don’t know is that allergies can be a big issue for people dealing with acid reflux disease. Separate from food allergies, seasonal allergies can also play a role in exacerbating the symptoms of acid reflux.

The link between seasonal allergies and acid reflux disease is that as allergic response becomes more active, one has more nasal drip, and more nasal drip leads to more acid, and that acid can then reflux up into the nasal passages and make the whole cycle even worse. In addition, one of the ways that seasonal allergies can aggravate acid reflux disease is the pressure from coughing or sneezing. This pressure can temporarily weaken the lower esophageal sphincter (LES) and allow stomach contents to splash into the esophagus. In order to get the added acid reflux pain under control, suffers also need to get the drainage, sneezing and coughing under control.

The first line of defense in the seasonal allergy arsenal is generally the use of antihistamines. Medications provide a way to lessen the reaction the body has to the histamines produced by allergies. These medications can help many people deal with their allergies without any further treatments.

Senior man with reflux

If you do need antihistamines in the pollen season, remember that they can dehydrate and cause constipation. The latter is also a huge reflux trigger. Be sure to drink plenty of water and gradually increase your fiber intake to counteract any unpleasant side effects. You don’t want to trade one reflux trigger for another.

There are a few things that you can do this time of year to help lessen your increased acid reflux symptoms due to allergies:

  • Even though the weather this time of year can be gorgeous, keep the windows closed in at least one room of your house. Spending time in this room throughout the day will give your entire bodily system a break from the environmental stress being placed on it.
  • Shower and change clothes after working or being outside. Most aller
    gens cannot be seen. Especially on a windy day, just assume that if you have been outside, you are wearing allergens when you come inside.
  • Be proactive with your reflux medication and your allergy medication this time of year. Reflux comes in waves. One of the best ways to manage reflux is to understand ahead of time when your reflux may be troublesome and manage accordingly. An antihistamine can be helpful. It works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. This medication can also slow down your runny nose and nasal drip whichin turn can help your reflux symptoms.
  • Do not experiment with new foods. Keep your eating very simple and reflux friendly until at least the first frost in your area.
  • Avoid raw fruits and vegetables. Allergens can be found in our environment and also in raw fruits and some vegetables. These same foods can often be better tolerated cooked. When foods are heated, the proteins are distorted and the immune system no longer recognizes the food as a problem.

If you live in the Las Vegas area and are suffering from acid reflux. Schedule a consultation at VIP Surg. We can help find the right treatment for you.