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.

 

 

Advertisements

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.

 

Eating in Moderation: What Does that Really Mean?

“Everything in moderation,” says a co-worker, dipping the tines of her fork into her low-fat salad dressing.

“Everything in moderation,” says a friend helping himself to a third scoop of ice cream.

What is moderation? If this concept of moderation confuses you, you’re not alone. Everyone appears to define it differently. Eating in moderation is a subjective term, meaning something slightly different depending on your perspective. Individual perception of reasonable limits opens the door to a wide variety of complex answers for a seemingly simple question.

On one end of the spectrum, there are those who don’t put much thought into eating a healthy and well-balanced diet. Convenience and taste are the main factors influencing their dietary decisions.

On the opposite end, one may find those who label food as either wholesome and pure or downright evil, with seldom anything in between. Typical “bad” foods such as sugar, carbs, dairy, and processed or refined foods are avoided at all costs.

Both extremes can have detrimental effects on health. Eating calorie-dense foods high in sugar, fat, and salt on a regular basis, combined with a sedentary lifestyle increases the risk of chronic diseases like heart disease, obesity, and diabetes.

However, cutting out entire food groups without replacing missing nutrients can also pose problems. While “clean eating” might come in an attractive package, severe restrictions can lead to cycles of binge eating, feelings of guilt and shame, and further restriction.

Toward which end of the spectrum do you tend to lean? Where is the fine middle ground?

Eating in moderation means you do not consume more calories than your body needs to function properly. A person who does not eat a moderate number of calories gains weight, risking obesity and its associated illnesses.

The quality of the food is also an important factor when talking about eating in moderation. Consuming food your body does not need or want, such as excess sugar and fat has a detrimental effect on your body.

Eating in moderation means consuming nutritionally dense food so your body gets all the vitamins and minerals it needs without harmful or needless substances. According to the MyPlate scheme from the USDA, a healthy dinner plate contains lean protein, whole-grain foods, fruits and vegetables.

Plan your plate to ensure you are eating the proper foods in moderation. Draw an imaginary line down the middle of your plate. Fill the left half your plate with fruits and vegetables. Draw another imaginary line to cut the right half of your plate into two quarters. Fill one section with lean meat and put whole-grain products in the other section.

Moderation is about a healthy relationship with food – balancing the pleasure of eating with our basic need for sustenance. It is realizing that eating one piece of cake a week probably won’t kill you, but that doing so everyday just might.

If you live in the Las Vegas area and are fighting obesity and metabolic disease, schedule a consultation at VIP SURG. We can help you find the right treatment for your unique situation.

The True Size of the American Obesity Epidemic

To understand the true magnitude of the American obesity epidemic, we first need to understand what it really means to be overweight. Doctors and nutritionists classify people as either underweight, healthy weight, overweight, or obese. These different classifications are determined by body mass index (BMI), or a measure of body fat based on your height and weight.

To get a basic idea, this chart from the CDC approximates what that means for someone who is 5’9” tall.

Height Weight Range BMI Considered
Source: CDC      
5′ 9″ 124 lbs or less Below 18.5 Underweight
  125 lbs to 168 lbs 18.5 to 24.9 Healthy weight
  169 lbs to 202 lbs 25.0 to 29.9 Overweight
  203 lbs or more 30 or higher Obese

As for what is driving America’s chronic weight problem, there are no definite answers. Scientific studies often reach conflicting conclusions. Many theories are out there, but the preponderance of evidence points to the two causes most people already suspect: too much food and too little exercise.

Bigger portions, confusing “diet” for “nutrition,” and lack of exercise are a deadly combination. Today, each American puts away an average of 195lbs of meat every year, compared to just 138lbs in the 1950’s. Consumption of added fats also shot up by around two thirds over the same period, and grain consumption rose 45% since 1970.

Research published by the World Health Organization found that a rise in fast food sales correlated to a rise in body mass index, and Americans are notorious for their fast-food consumption. It is not just how much we eat, but what we eat.

The role of diet in the obesity epidemic is obviously major, but it’s also complex. Consumers are sent mixed messages when it comes to what to eat and how much. Larger portions, processed packaged food, and drive-thru meals are branded as almost classically American — fast, cheap, filling, and delicious, but yet we spend billions of dollars annually on weight loss schemes.

Lack of exercise is also a major culprit in the obesity epidemic. A far greater majority of us are sitting throughout our workday. According to one study, only 20% of today’s jobs require at least moderate physical activity, as opposed to 50% of jobs in 1960. Other research suggests Americans burn 120 to 140 fewer calories a day than they did 50 years ago. Add this to the higher number of calories we are packing in, and we get a perfect recipe for weight gain.

A number of other factors are thought to play a role in the obesity epidemic, such as the in- utero effects of smoking and excessive weight gain in pregnant mothers. Poor sleep, stress, and lower rates of breastfeeding are also thought to contribute to a child’s long-term obesity risk. Of course, these factors are not explicit or solitary causes of obesity, but they are reliable indicators of the kinds of systemic problems contributing to this crisis.

In the end, though, we can’t lose sight of the big picture. Over the past years, diet fads have come and gone, with people rushing to blame red meat, dairy, wheat, fat, sugar, etc. for making them fat, but in reality, the problem is much simpler. Genetics and age do strongly influence metabolism, but as the CDC points out, weight gain and loss is primarily a formula of total calories consumed versus total calories used.

If you are looking for answers to debilitating obesity and the health issues that often accompany the extra weight, contact VIP Surg at (702) 487-6006. We can help you find the right treatment for your unique situation.

A pair of female feet on a bathroom scale

Your Chemical Romance

It’s no secret that many of us eat for emotional reasons, but did you know that research suggests that the brain circuit for eating overlaps with the brain circuit for interpersonal relationships? The neurobiology suggests that improving social relationships can actually help you lose weight. There may even be a few ways to trick the brain to achieve the same effect.

The neurotransmitter responsible for close, trusting relationships is oxytocin. Oxytocin is released by physical contact and supportive interactions with other people. Release of oxytocin increases feelings of trust and generosity. It also reduces feelings of stress and anxiety.

Amazingly, the act of eating actually releases oxytocin. In fact, eating releases oxytocin in dopamine rich brain areas, which helps explain why eating can be soothing and pleasurable. After all, part of the reason we’re drawn to emotional eating is that eating mimics the same feelings of comfort we get from close friends and family.

If you’re trying to lose weight, try boosting your oxytocin. Luckily, the best way to do that is to improve the quality and closeness of your relationships with family, friends, and significant others.

It seems like a simple suggestion, but unfortunately, problems with these relationships are often what triggers emotional eating in the first place. As a temporary measure — while you’re working on your relationships — here are a few ways to boost your oxytocin that don’t involve snacking:

  • Get a massage. Physical contact with another person is the surest way of boosting oxytocin. If you’re not in a relationship, it can be difficult to accomplish that. If you are in a relationship, then yes, your partner is a great source of oxytocin, but don’t rely on getting all your oxytocin from one person. Getting a massage releases large amounts of oxytocin, and will help you de-stress.
  • Say or do something nice for a friend. When other people trust and rely on you it boosts your oxytocin. Showing support for someone else helps that happen.
  • Pet a pet. Petting furry pets, whether it’s yours or someone else’s can help increase oxytocin. Part of it is their furry warmth, and part of it, particularly with dogs, is their trust in you. Being trusted helps increase oxytocin whether it’s a person or a dog.
  • Hug a friend. Ask a friend for a long hug, or ask them if they would like a hug. Hugs, particularly long ones, release oxytocin. In fact frequent hugging not only increases oxytocin, it also decreases blood pressure.
  • Have a conversation (in person or on the phone). The human voice can release oxytocin in ways that the written (or texted word) doesn’t.
  • Have a warm cup of tea while wrapped in a blanket. Physical warmth helps promote feelings of trust and generosity.

If you live in the Las Vegas area and are looking for ways to treat your obesity and the diseases that often accompany it, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can help you find the best treatment for your unique situation.

Happy group of diverse people, friends, family, team together

Fitness Trends for 2017

We’re more than a month into 2017, but you still might be wondering what’s trending in the fitness world this year. While the following certainly aren’t “new,” and this list includes only few of many options, these trends will be huge this year according to an annual report published by the American College of Sports Medicine (ACSM).

  • wearable tech
    • Fitness trackers and smartwatches have been hot holiday gifts for the last few years, and the ACSM says that trend won’t be going anywhere in 2017—and in fact, it will only get bigger. Today’s wearables track distance, and also provide heart rate readings, GPS route tracking, move reminders, and much more. Recent updates from brands like Garmin, Apple, and Fitbit have sent the trend to number one for this year.
  • body weight training
    • It’s easy to see why no-equipment workouts are popular. They’re relatively easy to learn, they can be modified to suit any ability level, and they can be done just about anywhere. Plus, body weight exercises are an efficient way to get fit for free. Pushups and pull-ups are classic bodyweight moves, but there are plenty more to choose from, like squats, lunges, and planks, just to name a few.
  • high-intensity interval training (HIIT)
    • HIIT helps torch calories fast by alternating quick bursts of high-intensity exercise with short rest periods. It can be found in all types of workouts, from Pilates to CrossFit and boot camp classes. To try a high-intensity interval training workout yourself, spend 20 to 30 minutes total combining repeated short bursts of work with short break periods, like 45 seconds of burpees with 15 seconds of rest followed by 45 seconds of squats.

Keep in mind that in addition to helping to maintain a healthy weight, regular exercise lowers your risk of heart disease, stroke, cancer, dementia, and other chronic diseases, and serves as a powerful stress-reducer and mood-booster. With obesity and its accompanying health problem on the rise, using exercise as a preventive health tool is perhaps more important than ever.

If you live in the Las Vegas area and are looking for ways to treat obesity and metabolic disorder, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can help find the right treatment for you.

 

Workout Trends card with a beach on background

Instead of Making Yourself Over this Year Make Over your Resolutions

The new year is here, and if you are like many, many people you’ve made resolutions about how you’re going to lose weight, exercise regularly, and generally live a healthier lifestyle starting now. Of course, these are all noble goals; unfortunately the hordes of people who will be back to their old ways by the end of the month far outnumber those who keep true to their intentions.

Perhaps the top reason that well-meaning “resolution-ers” fail is that the goals they set for themselves are unrealistic and set up to fail from the beginning. This year, instead of making over yourself, here are some tips to makeover your resolutions. This year, resolve to be successful!

Old resolution: I am going to lose weight—somehow. Making list of New Year's resolutions
People often will just set a weight-loss goal, but they don’t have a good plan on how to get there. Without a detailed plan, you’re likely to go back to previous eating and exercise patterns.
Makeover: Set a goal that is specific, measurable, realistic, and trackable. Walk for 15 minutes three times a week or add a serving each of fruits and vegetables. Focus on changes that you can make a part of your lifestyle seamlessly, so you’ll be able to sustain them for the long term.

Old resolution: That’s it, no more chocolate—ever!
Banning your favorite treat—whether it’s chocolate, soda, lattes, or french fries– is bound to backfire. Dieters often eat it, binge on it, feel bad, and then throw in the towel and revert back to their old eating patterns.
Makeover: Make peace with your trigger foods. Don’t have them at home staring you in the face, but allow yourself to have them once or twice a week.

Old resolution: Those holiday parties went straight to my hips. I’m going to have to starve
myself to undo the damage.
Too often when somebody says diet, they’re thinking deprivation. If your weight loss plan feels like a drag, you’re going to feel punished and abandon it.
Makeover: Rejoice in the lifelong health benefits you’ll be creating instead of getting down about dieting. Losing weight becomes easy when you invest your mental energy in making positive, healthy changes for yourself.

Drastic resolutions are simply not realistic. You’ll just get discouraged and give up. Instead, make some basic alterations to your lifestyle. These changes don’t all have to happen at once, but changes in what you eat, when you eat it, and how much you move your body will ultimately cause you to lose the weight. People who aren’t willing to change their lifestyle will never be successful with weight loss.

If you live in the Las Vegas area and are ready to change your lifestyle and do what it takes to finally be successful with weight loss, schedule an appointment with Dr, Shawn Tsuda. He and his expert team can help find the right treatment for you.