Non-Surgical Reflux Treatment: What is GERDX?
GERDX is an innovative endoscopic method developed for non-surgical reflux treatment. Gastroesophageal reflux disease (GERD) is a condition that occurs when stomach acid leaks back into the esophagus. This condition manifests itself with disturbing symptoms. The quality of life of a person experiencing reflux can decrease significantly depending on the existing symptoms. Therefore, it is a condition that needs to be treated. GERDX is applied to eliminate this problem without the need for surgery.
Non-Surgical Reflux Treatment: Who Can Get GERDX Endoscopic Treatment?
If GERDx symptoms cannot be controlled with lifestyle changes and medication, endoscopic treatment may be considered. If there are complications such as esophagitis, erosion, ulcers or a narrowed esophagus caused by GERDx, endoscopic treatment may be required.
Endoscopic treatment is sometimes considered as an alternative to open surgery. This method is less invasive and may require less recovery time.
Some patients may be at high risk for open surgery, so endoscopic treatment may be a safer option for these patients.
GERDx endoscopic treatment aims to improve the lining of the esophagus or to restore the function of the valve between the stomach and esophagus.
These procedures are performed through a thin tube called an endoscopy and usually require a short hospital stay.
However, who can receive GERDx endoscopic treatment may vary depending on the patient’s specific condition and the severity of their symptoms.
For this reason, it is important for people with symptoms to talk to their gastroenterologist or internal medicine specialist to determine the most appropriate treatment option.
Who is Not Applied with GERDX Endoscopic Treatment?
- Patients with a valve level of level 4 (last level). (During the endoscopy procedure, the patients’ valve levels are measured and if they are not suitable for the ARMA procedure, the procedure is not performed.)
- Patients with a stomach hernia greater than 2.5 cm.
- Patients who have undergone stomach surgery and whose stomach volume is not yet large enough for the procedure.
GERDX procedure is not suitable.
What is The Difference Between GERDX and Other Treatments?
If reflux disease is not treated, it can lead to more serious health problems, so it is important to receive medical treatment.
While drug treatment generally provides temporary relief for the patient, it does not provide definitive treatment.
Although the success rate of surgical treatment is higher than drug treatment, it causes patients to experience the disadvantages of surgery. Patients prefer the surgical method less due to the general anesthesia effect the patient receives during the surgery and the surgical wounds that occur on the patient.
Non-Surgical Reflux Treatment: What are the Advantages of GERDX?
- Since it is a non-surgical method, no surgical incision is made,
- Patients can usually return to their normal lives in a short time,
- Permanent results are obtained with the GERDX method,
- The risk of complications is lower compared to surgery,
- Most patients can be discharged on the same day,
- Light sedation or local anesthesia is used instead of general anesthesia,
- Since it is an endoscopic method, it is more comfortable for the patient.
Non-Surgical Reflux Treatment: How is GERDX Treatment?
Medication Use in Reflux Treatment
- Medications used in reflux treatment cannot heal an inflamed esophagus. If medical treatment does not work, surgical treatment is considered.
- Medications such as Gaviscon, Rennie, Talcid immediately affect the complaints. Excessive use of these medications can cause side effects such as diarrhea or constipation.
- The effect of H-2 blockers such as famotidine and ranitidine does not start as quickly as antacids, but they reduce stomach acid by 70% for a longer period of time, approximately 12 hours.
- PPIs such as omeprazole, esomeprazole, lansoprazole, rabeprazole are stronger than H-2 blockers and allow the damage in the esophagus not to progress. Long-term use of these medications causes B-12 deficiency.
Surgery in Reflux Treatment
- If medications do not work in reflux treatment or if the patient becomes addicted to medications, surgical treatment may be necessary.
- The fundus of the stomach is wrapped 360 degrees around the esophagus to strengthen the lower esophageal sphincter. It is essential to wrap the stomach as loosely as possible. Tight wrapping does not reduce reflux and causes stenosis.
- Recent reports have shown that this procedure eliminates typical symptoms of gastroesophageal reflux, such as pyrosis, regurgitation and dysphagia, in 90% of patients. Globally, there is a 4.2% conversion to open surgery, 0.5% early reoperation and a 91% excellent to good symptom improvement rate.
GERDX in Reflux Treatment
- GERDX is an endoscopic method used in the treatment of reflux disease worldwide for over 10 years.
- It is a different non-invasive endoscopic approach (no incision is made in the patient’s body) compared to surgery or a lifelong pharmaceutical treatment.
- Shortening of procedure time with endoscopic method (average 45 min)
- Shortening of hospital stay
- Minimizing pain sensation
- Reducing/preventing bleeding/discharge
- Increasing quality of life comes to the fore with providing independence in daily life activities
- It has the same success rate when compared to surgical method.
GERDX Procedure Steps
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Stage 1:
GERDX is performed inside the stomach using advanced endoscopy under general anesthesia.
Using a flexible endoscopic and a guidewire, the Applicator is gently inserted into the stomach through the mouth and esophagus. Under the visualization of the endoscope, the front part of the Applicator is completely bent backwards, the arms are opened and the tissue retractor is advanced into the tissue.
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Stage 2:
The tissue retractor can be advanced deep into the gastric cardia mucosa and retracted back into the open arms of the gastric wall Applicator. Thanks to the manipulating arms and the centrally located tissue retractor, a lot of tissue can be collected for subsequent suturing.
Since the integrated endoscope can move independently of the Applicator, excellent visibility is provided throughout the procedure.
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Stage 3:
The arms of the Applicator are closed under endoscopy visualization and a full-thickness duplication is created through all layers of the stomach wall.
It is extremely important to suture all layers of the stomach wall as this is the basis for a permanent result.
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Stage 4:
The suture system is opened, the tissue retractor is removed, and the applicator arms are reopened.
The pre-tied transmural cloth suture provides a full-thickness duplication and a tight closure of the gastroesophageal junction around the applicator shaft. In addition, the tissue is wrapped to recreate the natural flap-valve.
The arms are then closed again, the applicator is flattened, and the procedure is completed.
Recovery Process After Gerdx Endoscopic Treatment
The recovery process after Gerdx endoscopic treatment is generally uneventful. The patient may experience mild discomfort after the procedure, but this is short-lived. Liquids and soft foods should be preferred for the first few days. Medications should be used as directed by the doctor. The recovery period may vary from person to person, but most patients return to normal within a few days. It is important to follow the doctor’s instructions and help prevent complications.
