What Is The Les - Dr. Adam Braze of Kingman Thoracic Associates is trained to perform the minimally invasive TIF procedure. KRMC is the first and only hospital in the region to offer this advanced alternative GERD treatment.
If you or someone you know has chronic GERD, talk to your primary care physician or gastroenterologist about whether a TIF regimen is right for you; you can go back to your pill-free and heart disease-free life.
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Millions of Americans suffer from frequent heartburn, also known as acid reflux or gastroesophageal reflux disease (GERD). Until recently, the primary treatment for GERD was the use of medications that reduce stomach acid. But now, there is a very effective new treatment available at Kingman Regional Medical Center (KRMC).
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GERD occurs when the valve that prevents stomach acid from flowing into your esophagus (the tube that connects your mouth to your stomach) deteriorates. With GERD, the esophagus weakens or opens when it doesn't—allowing stomach juices to back up into your esophagus.
KRMC is the only hospital in the area that offers the TIF (transoral incisionless fundoplication) procedure to repair a non-functional valve. The method is done completely without any complications.
With TIF, you go under general anesthesia. While you are asleep, the doctor inserts an endoscope through your mouth into the esophageal valve. Using special instruments attached to the endoscope, the doctor can restore the natural shape, position and function of your esophageal valve – stopping the reflux.
Most TIF patients experience some discomfort after surgery. After a recovery period of four to six weeks, most people stop taking daily medications for GERD. In addition, patients experience side effects associated with traditional reflux surgery.
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KRMC Chest Surgeon, Dr. Adam Braze is the only TIF trained therapist in the tristate area. He said: "The TIF process can improve the quality of life of patients."
If you or someone you know has chronic GERD, talk to your primary care physician or gastroenterologist about TIF and a possible referral to Dr. Braze.
For more information on how TIF can get you back to a heart-free life, please call us at Kingman Thoracic Associates, 928-681-8520. The root cause of acid reflux is often ignored with short-term relief solutions. With the prevalence of acid reflux symptoms, GERD and heart disease increasing and traditional treatment options failing which often lead to more chronic problems, this is a blog post I like to create for my clients, and those who visit my blog. . , for a very long time. But, better late than never, right!?
From the underlying causes of acid reflux to diagnosis and natural remedies, here's what we'll cover:
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At the bottom of the esophagus (food pipe) is a muscle (sphincter) that allows food to enter the stomach known as the lower sphincter (LES). Working together with the diaphragm (also a sphincter), the two sphincters work together like valves, one in and one out, to constrict or expand the esophagus. The role of these two sphincters is to relax during a meal to allow food to enter the stomach and then close to allow the contents of the stomach—food and acid—back up to the esophagus and throat.
When these sphincters fail and stomach acid and food back up into the stomach and throat, it is called 'acid reflux'. Symptoms of acid reflux include:
> General complaints of gastrointestinal disorders such as nausea after eating, flatulence, flatulence and discomfort in the upper abdomen.
GastroEsophageal Reflux Disease is a more severe form of acid reflux. It's generally accepted that if you have acid reflux more than twice a week, you have GERD, but it's usually more common than that. The symptoms of GERD are similar to acid reflux but you may also have a cough, laryngitis, chest pain, asthma or poor sleep. NERD is non-erosive reflux disease. The symptoms may be the same but there is no erosion of the esophagus, and therefore no structural damage.
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Heartburn is a symptom of acid reflux and GERD. It doesn't affect the heart, but because the pain from acid reflux burns the throat and bladder, a burning sensation is felt in the chest near the heart area. In fact, it is often confused with angina or chest pain.
The lower hepatic sphincter (LES), diaphragm, phrenoesophageal ligament (the ligament that connects the esophagus to the diaphragm) and the gastroesophageal junction (GEJ) are the main components of the antireflux barrier. The GEJ is like a flap valve that works with the LES to stop reflux. Absence of the antireflux barrier is thought to be the main cause of acid reflux. I will explain more in the next chapter but for now let me say that the LES requires a lot of stomach acid to stay closed, and a little bit of stomach acid can cause acid reflux and GERD, NOT excess stomach acid. It doesn't matter if you have too much acid, if your LES is working properly, you are unlikely to experience acid reflux.
Stomach acid plays an important role in nutrition and the immune system. Not only does it break down food particles, it can kill unwanted pathogens and prevent them from entering other body systems. Food that is digested and swallowed is further broken down by stomach acid in the "turn and burn" process of digestion.
It is so important that we don't need to consciously control it. The beginning of a meal, even just thinking about it, stimulates the production of stomach acid when the meal is well digested. There are different stages at which stomach acid comes out but generally, by the time your first breakfast hits your stomach, your stomach juices are well and truly flowing!
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The fluid commonly referred to as 'stomach acid' is highly acidic and contains several components throughout the upper GI tract, including:
> Pepsin - digestive enzymes produced in the stomach that break down proteins. Pepsin is active at low pH (acidic environment).
Hydrochloric acid (HCL) makes up the majority of stomach acid, so it's important to know more about it and its important role in digestion and the development of acid reflux. > HCL has a pH of 0.5 to 3.0. The pH range ranges from very acidic (0) to alkaline (14). In comparison, battery acid and stomach acid have the same pH of 1-2. pH of water is 7, baking soda is 8-9 and ammonia is 11-12.
> HCL's role is to kill bacteria and other bad bugs in the food you eat. Levels below pH 3 are bactericidal (can kill) E. coli and H. pylori, among others.
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> HCL also stimulates LES (lower esophageal sphincter) closure which is essential to prevent acid reflux and GERD - more on this below.
> HCL activates the release of the enzyme, pepsin. As pepsin leaves the stomach, it works on proteins, breaking them down into smaller amino acids and peptides. These processes aid in the recovery of now broken down protein molecules throughout the rest of the GI tract.
> HCL stimulates the release of lingual lipase (in the mouth) as well as gastric lipase (in the stomach), an enzyme that helps break down fat into smaller molecules called glycerol and fatty acids.
> HCL also has the ability to convert minerals into nutrients that can be absorbed by the body. Low HCL excretion reduces the bioavailability of important dietary minerals, such as iron, zinc and calcium. That is, the body cannot absorb and use these minerals, and they are released with other waste.
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We're going to go into a bit of detail here so I'll give you the short answer, with diagrams, and then all the additional information below. In most cases, acid reflux is caused by:
Without these two, stomach acid would be present in the stomach and acid reflux symptoms would not be a problem. So the next question is: what causes harmful antireflux obstruction and abdominal pressure? The short answer, which is responsible for acid reflux in most of my clients, is: low stomach acid. And here's why...
Low stomach acid can cause acid reflux and GERD through two main mechanisms. The first is to do with the LES component of the antireflux barrier and the second is the effect on intra-abdominal pressure:
> Low stomach acid and antireflux obstruction - High stomach acid (low, or high pH) puts pressure on the LES which closes to prevent acid from flowing into the esophagus and causing symptoms. The LES works like a muscle and without stomach acid to keep it flexible, it can weaken and become less effective over time.
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> Low stomach acid and intra-abdominal tension - This can happen in a number of different ways
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