GERD Treatment

Depending on the severity of symptoms, treatment options for GERD may include:

• Diet and lifestyle changes
  • Avoid foods that can trigger symptoms, such as coffee, tea, carbonated beverages, fatty or spicy foods, citrus fruits, tomatoes, garlic, onions, peppermint or chocolate
  • Eat small, frequent meals 
  • Lose weight
  • Reduce pressure on the stomach with weight loss and loose-fitting clothes
  • Stop smoking
  • Avoid alcohol
  • Do not recline within three hours after eating
  • Raise the head of your bed six to eight inches to reduce nighttime reflux 
• Over-the-counter and prescribed medicines
• Conventional anti-reflux surgery

Your provider will discuss treatment options to find the best option.

TIF is a minimally invasive, outpatient procedure that is performed through the mouth to reconstruct the anti-reflux valve between the esophagus and the stomach. This valve opens and closes as food is swallowed and acts as a physical barrier to reflux. This procedure restores the body’s natural protection against reflux and eliminates the acidic symptoms of reflux, such as heartburn and sore throat, as well as the non-acidic, atypical symptoms such as asthma, chronic cough and regurgitation.

Benefits of the procedure:

• No scars
• Reduced risk and discomfort
• Faster recovery 
• Fewer adverse effects and complications
• Can be revised if required

Anticipated risks with the TIF procedure include temporary discomforts, such as sore throat, shoulder pain, difficulty swallowing, nausea or vomiting. Click here to learn more about the associated risks of the TIF procedure. 

TIF is an acronym that stands for

Transoral: The procedure is performed in the GI tract through the mouth

Incisionless: There are no incisions

Fundoplication: The anti-reflux valve is reconstructed by wrapping the upper portion of the stomach (fundus) around the esophagus

What to Expect with TIF Surgery:

Before Surgery

TIF is performed under general anesthesia, so patients must refrain from eating and drinking for several hours prior to the procedure.

During Surgery

TIF generally takes less than an hour. The surgeon will insert a device called EsophyX, which is used to reconstruct the anti-reflux valve. An endoscope also will be inserted that allows the surgeon to see the inside of the esophagus. The upper portion of the stomach is wrapped around the damaged lower portion of the esophagus and secured with poly-propylene fasteners, which are left in place to secure the newly constructed valve while healing occurs.

After Surgery

Specific, individualized instructions, including for diet and physical activity, will be given to each patient after surgery. Most can return home the same or next day and can resume work and ordinary activities within a few days. Patients should expect some minor discomfort in their stomach, chest, nose and/or throat for three to seven days after the procedure. It’s important that patients comply with post-op recommendations for proper healing to avoid affecting the surgical repair.

Learn More

Here are some frequently asked questions and educational videos about TIF. You may also download this TIF informational brochure in English or TIF informational brochure in Spanish.

The most common anti-reflux surgery is known as a fundoplication. Fundo means top of stomach and plication means to fold. During the surgery, the upper portion of the stomach is wrapped around the end of the esophagus and stitched in place. This technique reinforces the anti-reflux barrier and the junction between the esophagus and the stomach.

When to Consider Anti-Reflux Surgery

Most people with mild GERD can successfully control symptoms through dietary and lifestyle changes or medication. For patients who experience inadequate relief and/or side effects from medication, surgical intervention may be appropriate. Surgery may be suitable for patients who have:

• Concerns about the long-term side effects or costs associated with medication.
• Certain complications of GERD, such as Barrett’s Esophagus.
• Symptoms of GERD outside the esophagus, such as asthma, hoarseness, cough, chest pain or aspiration.

Goals of Anti-Reflux Surgery

The goal of a fundoplication is to restore the normal functions of the junction between the esophagus and the stomach. Other goals include:

• Reduction of a hiatal hernia if present by repairing the enlarged opening of the diaphragm and ensuring the stomach and esophagus are properly positioned below the diaphragm.
• Restoration of the angle where the esophagus enters the stomach.
• Increased pressure of the muscle that controls the valve between the stomach and the esophagus to recreate a one-way valve to prevent reflux.

Types of Anti-Reflux Surgery:

Laparoscopic Surgery

A laparoscopic procedure involves accessing the abdomen via several small incisions. The patient is sedated for the procedure. A surgeon repairs a hiatal hernia, if present, before performing the fundoplication. Patients typically can return to work within one to two weeks.

It is important to remember that laparoscopic fundoplication is a surgical procedure with risks including bleeding, infection and injury to internal organs.

Comparison of TIF Procedure and Traditional Anti-Reflux Surgery

Among the treatments available to people with severe GERD-related symptoms, the more advanced options are the TIF procedure and traditional anti-reflux surgery. Both procedures have the same goal.

Traditional, or conventional, anti-reflux surgery is considered an effective solution for treating GERD. The surgery involves several abdominal incisions and typically includes side effects such as difficulty swallowing (26%), bloating (36%) and increased flatulence (65%).

The TIF procedure for chronic acid reflux treats the underlying cause of GERD without incisions. This procedure rebuilds the anti-reflux valve and restores the body’s natural protection against reflux. It follows the well-established principles of conventional anti-reflux surgery and delivers similar results in an innovative way.