You would think that with all the proton pump inhibitors (PPIs) and other heartburn remedies on the market, that most people eventually would come upon a solution for that constant burning sensation in the chest.
But about 20 percent of people with gastroesophageal reflux disease (GERD) -- the more serious form of chronic heartburn -- never find relief with conventional medications, says Johns Hopkins Medicine. Some patients take the next step: undergoing GERD surgery, with the intent often being simply to get off of long-term medication.
The surgery, however, is invasive and not always successful. That’s why Johns Hopkins and other medical centers are taking interest in two new surgical procedures: magnetic sphincter augmentation and transoral incisionless fundoplication. The first type is in clinical trials, while the second has won FDA approval and is now in use.
Before you get the details, though, here is a beautifully simplified description of the esophagus-stomach connection and the reason for GERD, from a Johns Hopkins newsletter:
“The main reason for GERD is weak muscular tension in the gastroesophageal sphincter, which is the valve that separates the stomach from the esophagus. This valve is supposed to stay closed unless you're swallowing food or liquids. But if the muscle becomes weakened and the valve opens from time to time, stomach contents can escape upward into the esophagus, causing the familiar symptoms of GERD: heartburn and indigestion.”
As for the two above-mentioned surgeries -- as “medicalese” as they sound -- they will provide an alternative to Nissen fundoplication. In this traditional procedure, the surgeon makes a wide incision in order to reach in and wrap the upper portion of the stomach around the esophagus.
This creates pressure on the sphincter muscle and strengthens it. The Nissen fundoplication also can be done laparoscopically, but that, too, takes several hours, and either method requires general anesthesia.
Clinical trials are underway on magnetic sphincter augmentation, also known as the LINX Reflux Management System.