Gastro-esophageal reflux disease (GERD) is a common gastrointestinal disorder with a significant proportion of patients becoming dependent on proton pump inhibitor (PPI) therapy. At the 21st Mumbai Live Endoscopy 2018,
Dr D Nageshwar Reddy, President, World Endoscopy Organization, briefed about the GERD-X.
He said, the patient with reflux esophagitis are treated with medications. These medications are called Proton Pump Inhibitors (PPI)s. “The problem is the access acid reflux esophagus. But unfortunately, the medications cannot do that. They can only suppress the acid. Various prokinetic medicines have been tried but they are not effective. As, none of the medicines increase the sphincter pressure. So, the reflux should be stopped mechanically. For which the next option is anti-reflux surgery, which is efficacious, but it has its own limitations,” explained Dr Reddy.
Speaking about the new technology, developed recently in Germany called GERD-X he informed, “It’s more physiological with the stapler device. We go into the stomach and put a small bariatric endoscope through the device and watch the device at the gastroesophageal (GE) junction. Then, we put 2 staplers at 5’o clock and 7’oclock position to tighten the GE junction which is tightened around the device itself. This device is called the GERD- X device.”
He added, “In India, we have conducted a study on 30 patients. In which, we found that in these 30 patients, 90 per cent of the PPI can stop completely and the reflux goes off.”
The ideal patients for this treatment:
- Patients who do not have large hiatus hernia
- Patients who do not have severe esophagitis which is of grade D.
Preparations before the procedure:
- It is out-patient procedure.
- The patient is required to fast for about 12 hours.
- The procedure has to be done under general anaesthesia.
- Pre-op check-up is conducted.
After the procedure:
- PPI is stopped for a week and majority of the patients do not require it.
- Some of the patients can experience mild chest pain which can last about 24 hours. So, analgesic or antacids can be recommended.
- No major complications.
- Avoid eating late in the night as the reflux can occur.
- There are no restrictions as the patients should lead a quality life.