Peter McConarty had been having weeks of chest symptoms - so much so, he visited the hospital three times.
“I was getting lots of pain that ran down both my arms,“ says the civil engineer from Pembroke. “I thought I was maybe having a heart attack.”
When doctors ruled out heart trouble, they diagnosed Peter with severe and persistent form of heartburn called Gastrointestinal Reflux Disease or GERD.
“Heartburn is caused by stomach contents regurgitating into the esophagus,” says Dr. Ram Chuttani, Chief of Interventional Gastroenterology at Beth Israel Deaconess Medical Center. “Some people can have this a couple of times a month and it’s easily treated with over-the-counter medications. But persistent reflux over several years can be dangerous.”
In fact, if left untreated, GERD can cause a number of serious complications including Barrett’s Esophagus, a condition which can lead to esophageal cancer. Other problems of chronic reflux include asthma, bronchitis, laryngitis, tooth decay and chronic sinusitis.
“GERD can affect a patient’s productivity - their employment and their ability to function daily so it’s very important to control gastroesophageal reflux disease,” says Dr. Douglas Pleskow, co-director of Endoscopy at Beth Israel Deaconess Medical Center.
Reflux disease usually results from a weakened or damaged sphincter, or valve-like muscle, located where the esophagus meets the stomach, which normally keeps the acid down. For most people, medications can control symptoms and keep the disease in check. Changing diet can also help.
But for others, more invasive treatments may be needed. The most common surgical procedure is known as Nissen Fundoplication. Now performed laproscopically, surgeons make five or six pencil-width size incisions to grab the upper part of the stomach and wrap it around the lower part of the esophagus creating pressure to keep stomach contents down. Patients are usually in the hospital for one or two days, and recover in a couple of weeks.
A newer option is the Plicator Procedure, which was developed at Beth Israel Deaconess Medical Center. A device called a Plicator is used to tighten tissue at the top of the esophageal junction. The procedure takes just 20 minutes, patients go home in a few hours, and most can resume their regular activities in a few of days. A recent study published in the Journal Surgical Endoscopy shows three years after having the procedure, 55 percent of patients had complete symptom relief, remaining off all medications.
Dr. Chuttani, who co-developed the procedure and has equity in NDO Surgical, the company that makes the device, points out that some patients are not considered candidates. They include individuals who never responded to medication and those with a large hiatal hernia. But he says it’s a less invasive option for others who suffer with GERD.
“For most people, the procedure makes a big impact on their quality of life,” says Dr. Chuttani.