GERD: Ways to Alleviate Symptoms

Heartburn is a very common symptom created by acid reflux, a condition where some of the stomach contents, including stomach acid, are forced back up into the esophagus, creating a burning pain in the lower chest. Persistent acid reflux that happens more than twice a week results in the diagnosis of gastroesophageal reflux disease (GERD). According to estimates from the American College of Gastroenterology, at least 15 million Americans experience heartburn – the symptom of acid reflux – every day.

Most people are occasionally affected by heartburn, which is rarely a significant cause for concern. Recurrent acid reflux, however, resulting in the diagnosis of GERD can have serious consequences for health.

GERD is seen in people of all ages, and the cause is often attributable to a lifestyle factor, but it can also be due to unavoidable factors such as anatomical abnormalities affecting the valve at the top of the stomach. However, changes to lifestyle or behavior can prevent or improve heartburn symptoms.

The American Gastroenterological Association offers the following list of things to try to see if symptoms resolve:

  • Avoid food, drinks, and medicines that you find to be associated with heartburn irritation.
  • Eat smaller meals.
  • Do not lie down for two to three hours after a meal.
  • Lose weight if overweight or obese.
  • Avoid increased pressure on your abdomen, such as from tight belts or doing sit-ups.
  • Stop smoking.

It is important to address persistent problems with gastroesophageal reflux disease as long-term untreated acid reflux can lead to serious complications including an increased risk of cancer.

    The following foods are known to aggravate acid reflux, and should be avoided:

    • fatty or fried foods
    • peppermint and spearmint
    • whole milk
    • oils
    • chocolate
    • creamed foods or soups
    • most fast foods
    • citrus fruits and juices (grapefruit, orange, pineapple, tomato)
    • coffee (regular and decaffeinated)
    • caffeinated soft drinks
    • tea
    • other caffeinated beverages
    • spicy or acidic foods may not be tolerated by some individuals

If you suffer from GERD, schedule an appointment at VIPSurg. They can help you find the right treatment for your unique case.

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Aging and Obesity: Is Bariatric Surgery an Option for the Elderly Patient?

The good news is that improved life expectancy is allowing baby boomers to enter their golden years in unprecedented numbers. The bad news is that rates of obesity among this aging demographic are climbing in never-before-seen numbers as well, putting this population at risk of developing cancer, heart disease, diabetes, lower extremity arthritis, sleep apnea, and stroke, all of which can lead to disability. Treatment guidelines to lose weight in the elderly have been difficult to define, yet it is very clear that obesity in the elderly contributes to worsening of multiple parameters which along with the metabolic problems mentioned already, include cognition, functionality and quality of life. While ample evidence supports the safety and effectiveness of weight-loss aka bariatric surgery in the general adult population, more information is needed in patients age 60 years and older.

Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; this is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population.

The risk of any surgical intervention increases as one gets older. However, weight-loss surgery is very safe, and the potential benefits routinely outweigh any of the associated risks if there are no other health issues that would dramatically increase the risk of surgery.

Ideally, a comprehensive assessment would focus on psychosocial and functional status in addition to physical data. An excellent support system of family, friends, or caregiver resources is imperative. The selected patient should be capable of engaging in physical interventions focusing on mitigating muscle loss and osteoporosis and of maintaining changes in eating behavior as needed as well. A recommended “pre-habilitation” program may include a physical therapist to assist with strength and endurance training and a nutritionist to aide in enhancing protein intake, vitamin D, and other nutrient sufficiency.

Identifying goals of care, quality of life, and improved function should be considered as primary objectives of undergoing surgery. Goals of the surgery include not only weight loss but also improvements in physiological function, comorbidity, and quality of life, and reduction in institutionalization.

If you live in the Las Vegas area and are considering bariatric surgery, VIPSurg is here to help. Dr. Tsuda and his team of experts can find the best treatment for your unique situation.

Old obese woman walking with stick

 

 

 

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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Plan for the Perfect 4th of July

Sunshine! Barbecues! Fireworks! The big national day is coming, and who doesn’t love a good July 4th celebration? If you’re planning on hosting or even just attending any of the festivities, planning and preparation can go a long way toward being safe and healthy this Independence Day. The fun times of the 4th can be fraught with peril if you’re not careful, but don’t worry; we’ve got the best tips to make sure this is your best 4th of July ever.

  • Bring some earplugs. A report from Loyola University Health System found that the sounds of summer—such as fireworks and marching bands—can damage your hearing. In fact, fireworks have a sound decibel of 150, and ear protection is recommended for decibels above 85. When noise is too loud, it begins to kill the hair cells and nerve endings in the inner ear; the longer you’re exposed to loud noise, the more likely you are to permanently damage your hearing. Toss some plugs in your bag or use your hands to cover your ears in a pinch. 
  • Swim in clear water. Swimming is great exercise, and a super way to cool off when overheated; However, a good rule of thumb is to only dip into clear, good-smelling water. For lake goers, make sure there isn’t any blue-green algae, or slimy, smelly, green film floating on the lake’s surface. Some forms of this can produce toxic bacteria that’s bad news for your health. 
  • Practice smart and safe eating. Keep from throwing your diet to the (hot) dogs by choosing wisely. Try to fill up on the delicious fresh fruits and veggies of summer instead of high carb, high calorie picnic foods. Choose lean proteins like skinless, grilled chicken over fatty burgers or ribs, for example. Avoid food-borne illnesses by eschewing mayonnaise-based salads. Instead go for options with oil and vinegar-based dressings which are generally lower in calories and risk of spoilage. 
  • SPF in advance. Applying your sunscreen in advance—and reapplying frequently—means you can significantly improve your skin’s protection from harmful rays.  
  • Follow the heat & humidity rule. To keep from dehydrating, implement the 70/70 rule: When the temperature and humidity are both above 70, you enter the dehydration danger zone. Stay safe by sipping frequently from a water bottle and drinking plenty of water before, during, and after activity.
  • Alternate your alcohol. If you choose to have a cocktail or two, the safest way to consume them is to make sure you have plenty of food in your stomach and to alternate each cocktail with a non-alcoholic beverage like water or decaf soda to help stave off alcohol-induced dehydration.

With a bit of preparation, some thoughtful food choices, and common-sense summer safety, you can have a wonderful holiday celebration. And don’t deprive yourself of a treat! Just choose wisely to get the most “bang” for your calorie choice. Happy holiday planning from all of us at VIPSurg.

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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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Stats Don’t Lie: Learn How Bariatric Surgery is Helping Hundreds of Thousands of People Regain Their Health

In the early nineties, fewer than twenty thousand bariatric surgeries were performed in the U.S. each year. Now the number is around two hundred thousand. Only in the past few years has what was once considered a high-risk and extreme measure been transformed into a relatively standard, safe, and straightforward one. There is strong consensus that bariatric surgery is effective, and Medicaid now covers it in forty-eight states. 

Research into conventional weight-loss methods has repeatedly pointed to an overwhelmingly dispiriting conclusion—that diet and exercise alone, no matter how disciplined the individual, fail all too often. Still, only about one per cent of those who medically qualify for bariatric surgery get it. 

Over the centuries, suggested strategies for losing weight have included bitter tonics, bleeding, sea air, amphetamines, Turkish baths, tapeworms, purgatives, low-fat diets, high-fat diets, cinnamon, more sleep, less sleep, and the “vigorous massage of the body with pea-flour.” Surgery is an old idea, too. One of the earliest surgical approaches to weight loss, dating back at least a millennium, was simple: the jaw was wired mostly shut. Another story from pre-anesthesia days tells of a rabbi “being given a sleeping potion and taken into a marble chamber, where his abdomen was opened, and many baskets of fat were removed.”

But the health risks associated with obesity have become apparent—higher rates of stroke and heart disease, Type 2 diabetes, infertility, sleep apnea, osteoarthritis, and an increased risk of certain cancers. In addition, bariatric procedures have improved dramatically. 

Robotic surgery and laparoscopy, which became the norm in the past decade, result in fewer complications like hernias. Physicians now have a better sense of how to prevent and treat the complications of surgery. 

As recently as seventeen years ago, there was a one-per-cent chance of dying from a bariatric procedure—a relatively high risk. Now it is 0.15 percent, which is less than that for a knee replacement, a procedure commonly recommended to people who have developed joint problems from carrying around excessive weight.

Around seventy-five per cent of bariatric patients have sustained weight loss five years after their surgery, and that percentage is higher if you don’t include lap-band patients in the analysis. Weight loss through diet and exercise rarely leads to more than short-term changes—a quite small percentage of patients see sustained weight loss. 

Today, obesity is second only to tobacco as a killer in this country. If you live in the Las Vegas area and are seeking long-term weight loss and health benefits, schedule an appointment at VIPSurg. We will help you find the best treatment for your unique situation.

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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.