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'Gastroesophageal Reflux Disease (GERD) & Swallowing Center' posts

Research on LINX recently published

The Swedish Thoracic Surgery team recently had results from a study published in Annals of Thoracic Surgery, "Short-Term Outcomes Using Magnetic Sphincter Augmentation Versus Nissen Fundoplication for Medically Resistant Gastroesophageal Reflux Disease", in which a retrospective case-control study was performed of consecutive patients undergoing either procedure who had chronic gastrointestinal esophageal disease (GERD) and a hiatal hernia of less than 3 cm. Based on the study, the LINX device appears to restore the sphincter barrier function and preserve normal physiology which enables belching and vomiting.

Updates on LINX - GERD reflux management system

Since my initial LINX blog post 20 months ago, we have been engaged in a dialogue with patients from around the world who suffer from gastroesophageal reflux disease or GERD.  Despite my initial trepidation to “blogging”, this has been a rewarding experience to hear about patient’s problems, their concerns about the current treatments (PPI’s and Nissen fundoplication) and simply interacting with them.  I thank the patients who have taken time to share their thoughts on the blog.

 

When our social media manager asked me to provide an update on LINX, I realized that I have been simply responding to patient’s questions and I haven’t posted any of my thoughts or updates on what is happening with the LINX device.

There are some exciting developments for patients who are interesting in having a LINX implanted.

 
Use of MRI and LINX
  • Torax, the company who designed and manufactures the LINX device, has received FDA support for the use of MRI with the LINX device.  This conditional approval allows for patients to undergo and MRI that is 0.7 Tesla or less.   I am trying to clarify with our radiologists what a 0.7 Tesla MRI will cover.
Medicare coverage
 
  • For medicare patients, LINX now has a dedicated procedure code that allows for payment to cover the cost of the hospital portion of implanting the LINX device.  The surgeon’s fee is a separate code and fee and is usually covered.
Insurance update
 
  • For patients with non-medicare insurance, the ...

Troubles swallowing food or liquids – what does it mean?

Dysphagia refers to the sensation of food or liquid being delayed or hindered from the mouth to the stomach.  This abnormality is increasingly recognized as an important concern that requires attention and study.  There are many causes of impaired swallowing, which are categorized into two types, mechanical, a structural barrier to food bolus movement, and motility disorders, involving abnormal muscle movement.  There are also two major anatomical sites, oropharyngeal and esophageal. 
 
Oropharyngeal dysphagia is related to problems with the initiation of the swallows and clearing the food bolus from the mouth to the esophagus.  This usually occurs within a second of swallowing and you may feel that you cannot initiate a swallow or food hangs up in the neck region.  A test that is commonly used to evaluate this is a modified barium swallow or videofluoroscopic swallowing study.  This study provides critical information on inability or excessive delay in initiation of swallowing, unintentional inhalation of food, unintentional expulsion of food from the nose or mouth, and/or abnormal retention of food in the back of the throat after swallowing.  Most ...

Technology can assist in diagnosis of heartburn, acid reflux and GERD

You may frequently interchange the terms heartburn, acid reflux and GERD, but it’s important to know if your heartburn is chronic and recurring.  Heartburn is a symptom we experience when acid from the stomach passes up through the esophageal sphincter into the esophagus, known as acid reflux.  For some people this can be acid that passes only a few inches up the esophagus or all the way to the mouth.  When acid from your stomach comes up as high as your mouth, you run the risk of aspiration (when fluids either going down to your stomach or coming up from your stomach enters your trachea and into your lungs). 

Gastroesophageal reflux disease (GERD) is described as severe or chronic acid reflux. Severe means that it happens when we have had a change in our body, like a pregnancy that causes pressure on our stomach forcing stomach content up into the esophagus. Chronic may mean there is a mechanical problem like a weak esophageal sphincter or a hiatal hernia that allows leakage into the esophagus. 

Whether intermittent, severe or chronic, acid reflux can feel miserable if it is not controlled and it can also cause cancer. We all suffer from heartburn from time to time, but when heartburn happens regularly or does not resolve with lifestyle or diet changes you may need to seek the assistance of a physician who can help you resolve it. Thankfully over the last 20 years, physicians’ ability to diagnose and treat these conditions has benefited by some excellent technology.

The first step to ...

Swedish Digestive Health Network – call 1-855-411-MYGI (6944)

In the fall of 2011, Swedish opened the largest, most advanced endoscopy center in the Pacific Northwest. This state-of-the-art unit serves as the procedural space for a broad range of minimally invasive cases performed by gastroenterologists, colorectal specialists, thoracic and bariatric surgeons and pulmonologists on patients with a broad range of digestive and respiratory diseases.  As we celebrated this accomplishment, we were reminded of the complexity of digestive disease and that many times, patients and possibly even referring physicians aren’t sure of what type of specialist is best suited to a particular digestive problem.

There is nothing more distressing as a health care professional than hearing patient horror stories about trying to access care. A chronic illness can cause depression and discouragement; an acute illness or a cancer diagnosis can overwhelm the patient and the patient’s family with plenty of unknowns. 

To address these challenges, a group of 50+ specialists came together and created the Swedish Digestive Health Network.

The Swedish Digestive Health Network focuses on collaboration to ease the way for ...

Surgical treatment options for GERD

Gastroesophageal reflux disease (GERD) is the most common disorder of the upper gastrointestinal track.  It's estimated that up to 40% of Americans take some form of anti-acid medication at least once a month, making it one of the most commonly used types of medication in the world. 

Heartburn is simply a burning sensation behind the breast bone, and is not necessarily from GERD.  It can be caused by a variety of other disorders, including heart disease, musculoskeletal disorders, and disorders of other parts of the gastrointestinal track, including the stomach, pancreas, gall bladder, liver, or intestine A simple way to differentiate GERD from heartburn is to take antacids or over the counter acid suppressants.  There are two classes of acid suppressants: H2 blockers like ranitidine/zantac; and proton pump inhibitors (PPIs) like prilosec/omeprazole.  If the symptom partially or completely responds, it is likely caused by stomach acid, particularly GERD.

How is GERD managed?

GERD is rarely life-threatening and can generally be managed symptomatically.  Some may ...

Dysphagia and Stroke

Gulp! 

Dysphagia (difficulty swallowing) is a common challenge for stroke survivors.  Up to 78% of stroke patients will experience some degree of dysphagia with those patients being 7 times more likely to develop aspiration pneumonia.  Aspiration occurs when, instead of being swallowed, food or beverages are inhaled into the lungs.  This can lead to pneumonia and possibly death. 

It is vital to follow....

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