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Houston Heartburn And Reflux Center

Is Nissen Fundoplication Covered By My Insurance

Treatment for Heartburn and Acid Reflux

John from Houston sent us this question: I was suggested to get a Nissen Fundoplication after a Gastroenterologist saw I disqualified for TIF procedure. I am worried about Nissen fundoplication potential side effects. I used to be a highly active person. Epigastric pain every day. Does insurance cover expenses? Thank you.

Dear John,

TIF and LINX procedures are not always covered by insurance because they are not effective and reliable treatment options for GERD. Nissen fundoplication, on the other hand, is always covered by insurance. A properly performed Nissen fundoplication has a very high success and safety rate. Indeed, a properly performed Nissen fundoplication is first line treatment for acid reflux disease. Nissen fundoplication side effects, when surgery is performed by expert hands, are rare. Side effects like difficulty swallowing and bloating after surgery are very rarely encountered at Houston Heartburn and Reflux Center.

Consequently, a properly performed Nissen fundoplication improves quality of life. Unlike TIF and LINX surgery, Nissen fundoplication effectively and reliably restores your anti-reflux barrier. As a result, you no longer need to avoid certain foods or take acid reflux medications like Proton Pump Inhibitors. Nissen fundoplication surgery stops all acid reflux related symptoms, and when properly performed, it will give you back your normal active life.

Innovative Care For Acid Reflux

While older surgical treatments for gastroesophageal reflux disease include significant side effects, the innovative LINX procedure maintains patients anatomy while providing immediate and lasting results. Hear more about this procedure from Dr. Yong Choi, board-certified surgeon at St. Lukes HealthThe Woodlands Hospital.

Houston Acid Reflux Specialist

Houston Heartburn and Reflux Center, the practice of Dr. Elias Darido, is dedicated to the treatment of heartburn, acid reflux surgery, and other disorders affecting the gastro-esophageal area. Dr. Daridos goal is to provide excellence in treatment along with compassionate care in a highly specialized treatment center. Dr. Darido is renowned for his expertise in advanced minimally invasive reflux surgery . Read more.

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Dysphagia And Persistent Acid Reflux After Linx Surgery

Sunny from San Antonio, TX sent us this question: I had LINX device placed on September 1, 2020. I have realized that eating fast causes Dysphagia. My two questions are:

Q1. Even chewing food well before swallowing I have experienced dysphagia, where taking a few sips of warm water gets my food down. Is this normal?

Q2. Even with LINX can one experience spontaneous reflux? Thank you.

Dear Sunny,

Dysphagia or difficulty swallowing is very common after LINX surgery. LINX device creates a barrier against normal swallowing. This physical barrier has three components: lower esophageal sphincter pressure, esophagus wall compliance and diameter. As scar tissue forms around LINX device, both esophageal wall compliance and opening decrease. Furthermore, LINX device, a bracelet of magnetic beads, increases lower esophagus sphincter resting and residual pressures. As a result, your esophagus works harder to push food across this barrier leading to dysphagia. The weaker your esophageal contractions the more likely you are to feel dysphagia. You may have to drink some water to help food go down. In some cases, food doesnt go down and it gets impacted in the esophagus. Over time, esophagus motility may further deteriorate leading to worsening dysphagia.

To conclude, dysphagia and LINX surgery go hand in hand given the device mechanism of action. A well performed Nissen fundoplication, on the other hand, is associated with less than 1% dysphagia rate.

What Types Of Acid Reflux Surgery Are There

Houston Heartburn and Reflux Center

Acid reflux surgeries include:

Nissen fundoplication

Nissen fundoplication is a well-established form of acid reflux surgery. It involves wrapping the stomach around the lower part of your esophagus to reinforce the lower esophageal sphincter.

Your provider at GI Specialists of Houston, LLP, performs Nissen fundoplication using minimally invasive laparoscopic techniques that only need small incisions. This approach means you experience less pain and recover more quickly from acid reflux surgery.

LINX® device

The LINX device is a ring of beads that mimics the action of your lower esophageal sphincter. Your surgeon uses endoscopic techniques to fit the LINX device around the LES. LINX reinforces your LES and prevents acid from refluxing out of your stomach.

Dr. Iduru at GI Specialists of Houston, LLP, is the only surgeon who performs this type of procedure in the entire area.

If you’re experiencing acid reflux, get the treatment you need to relieve your symptoms by calling GI Specialists of Houston, LLP, today or book an appointment online.

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Linx Surgery At Houston Heartburn

LINX Reflux Management system consists of a bracelet of magnetic beads that is placed around the esophagus to reinforce the weakened lower esophageal sphincter. LINX procedure is done under general anesthesia using the same approach as a laparoscopic Nissen fundoplication.

During swallowing, as food passes through the esophagus, LINX magnetic beads separate allowing the food bolus to pass into stomach and then close preventing acid reflux.

LINX procedure is a new device used for the treatment of GERD. Long-term studies related to efficacy, durability and safety of this treatment modality are still lacking.

A recent study published in the New England Journal of Medicine showed that acid reflux improved in 64 % of patients undergoing the LINX surgery. The most frequent side effect of the surgery was difficulty swallowing occurring in two thirds of the patients immediately after surgery. Difficulty swallowing persisted in 10% of patients for one year after surgery. The study concluded that LINX surgery improves reflux symptoms and allows patient to stop their anti-reflux medications. LINX however is a new surgery and long-term follow-up studies are needed to confirm these early results.

How Do I Know If I Have Gerd

It is crucial for your health that GERD is correctly diagnosed. Heartburn can be part of a more serious condition requiring advanced treatment. If left undiagnosed or untreated, acid reflux can cause damage to the esophagus, tooth decay and can lead to esophageal cancer. There are several tests to help diagnose GERD:

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Relief From Painful Heartburn Symptoms Is Possible

LINX® System

The LINX® Reflux Management System is an innovative surgical procedure to permanently treat the underlying causes of GERD symptoms. This procedure is performed laparoscopically and utilizes magnetized titanium to prevent acid from pushing up through the esophagus. LINX® is often used to treat patients who no longer find relief from medications.1

High Dose Proton Pump Inhibitors Are They Any Good

A Unique Center Dedicated For Acid Reflux Treatment

Lindsey from Houston sent us this question: I am on 40 mg of pantoprazole 2 times a day. I am not getting heartburn, but I am getting a lot of fluid in my throat and a cough with it. I get a tickle on the left side of my throat and start to cough, and then I choke until I cough up the fluid. I tried to find a diet for acid reflux online, but it is impossible. Could you please help me with any of this?

Dear Lindsey,

High dose proton pump inhibitors like 40 mg of Protonix, Nexium, or Dexilant taken twice daily are rarely indicated. Several studies in the literature have demonstrated comparable efficacy of standard and high dose PPI in terms of heartburn control. Furthermore, PPIs neutralize stomach acid but do not stop gastric content reflux into esophagus. Consequently, as you have eloquently described in your question, acid reflux patients on PPIs, continue to experience food regurgitation and throat irritation in the absence of heartburn. Weakly acidic or non-acid fluid escapes the stomach across a weak anti-reflux barrier. At the throat level, it causes cough, globus, throat clearing, hoarseness, and voice fatigue. In some cases, patients report choking at night. In addition, aspiration pneumonia and asthma may develop. Increasing PPI dosage or changing PPI brand name is common among gastroenterologists. However, these measures are not associated with improved acid reflux symptom control.

Read Also: What Can You Do To Help With Heartburn

Could Your Heartburn Be Caused By Gerd

Gastroesophageal Reflux Disease is a progressive condition that affects the digestive system. GERD is typically caused by a weakened Lower Esophageal Sphincter , which is a muscle that is located in the lower esophagus. The LES serves the important function of keeping stomach acid where it belongs. When the LES isnt working properly, stomach acid can splash back into the esophagus, resulting in acid reflux. GERD is characterized by chronic acid reflux, which can cause debilitating pain and can also lead to more serious conditions such as esophageal cancer. Learn More About the Connection Between Heartburn and GERD.

I had my heartburn issues corrected with the Lynx procedure in June 2018. Dr. Yu and his team at TLC Heartburn Center are incredible! My heartburn is gone, I feel great and can enjoy my life heartburn free!! Thank you

Meet Our Nurse Practitioner

Vanessa Hargett, RN, FNP-C, graduated with her bachelors in nursing from Stephen F. Austin State University in 2008. She began her nursing career as an intensive care unit charge nurse and went on to pursue her masters degree, graduating with honors from the University of Texas Health Sciences Center in 2014. Her degree as a family nurse practitioner allows Vanessa the ability to manage the continuum of care for patients with heartburn and acid reflux. She has cared for patients with every stage of GERD. Her current role allows her to guide patients through treatment options, assisting with testing and surgeries as needed.

Hours

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What Causes Heartburn And Gerd

The cause of acid reflux, heartburn or a chronic cough isnt always apparent. Many conditions may occur to cause an increase of acid in the stomach.

Obesity

For individuals with a BMI over 30, excess weight on the abdominal wall and increased intra-abdominal pressure can contribute to chronic heartburn and acid reflux.

Hernia

Heartburn is commonly caused by a hiatal hernia, or esophageal hernia. This is when the upper part of the abdomen pushes up through the diaphragm, allowing acid to reflux into the esophagus.

Pregnancy

During pregnancy, many women develop heartburn or acid reflux, which can worsen as the pregnancy continues and pressure on the diaphragm increases.

Smoking

Cigarette smoking can cause heartburn and acid reflux by increasing acid secretion, damaging mucous membranes, impairing muscle reflexes in the throat, and reducing salivation and diaphragm muscle function.

Trigger foods

Unfortunately, certain foods can cause heartburn . Trigger foods vary and can include alcohol, chocolate, carbonated beverages, tomatoes, spicy foods, fried foods, citrus, garlic, onions and acidic foods.

Can Covid Infection Cause Gastroparesis

An Evidence Based Approach to the Treatment of GERD ...

A small number of gastroparesis cases have been reported after presumed viral illness. Patients developed nausea, vomiting, and bloating immediately or several months after onset of viral infection. Gastric emptying study confirms delayed gastric emptying or gastroparesis. Management relies on pro-motility and anti-nausea medications. However, when symptoms persist, an antrum preserving partial gastrectomy is indicated to restore normal gastric emptying and improve quality of life.

Since the onset of COVID-19 pandemic, we have encountered one case of gastroparesis flare-up and one case of new onset gastroparesis and esophageal dysmotility immediately following COVID-19 infection.

The patient underwent an antrum preserving longitudinal gastrectomy with no complications. Her recovery was fast, and her gastroparesis symptoms resolved immediately following surgery. Repeat gastric emptying study 2 months after surgery showed normal gastric emptying rate.

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Dr Darido Holds The Following Designations:

  • Fellow of the American College of Surgeons
  • Board Certified The American Board of Surgery
  • Member American Society of Metabolic and Bariatric Surgery
  • Member Society of American Gastrointestinal Endoscopic Surgeons
  • Member American College of Surgeons
  • Member Texas Medical Association
  • Harris County Medical Association
  • Houston society of Bariatric Surgeons
  • Fellowship Trained in Advanced Laparoscopy Surgery
  • Fellowship Trained in Metabolic and Bariatric Surgery

Elias Darido, MD, FACS

Is Linx Surgery Appropriate For You

At Houston Heartburn and Reflux Center, each patient receives a thorough evaluation for heartburn and acid reflux. Depending on your reflux stage, Dr. Darido will recommend the appropriate treatment that suits you best. Reflux disease is a chronic and progressive condition and treatment is tailored accordingly. LINX surgery may be indicated for some patients. Please request an appointment to see if LINX surgery is appropriate for you.

Read Also: Why Wont My Heartburn Go Away

Patrick Ray Reardon Md

General Surgery Houston, TX

Dr. Patrick R. Reardon is a board certified surgeon with expertise in several areas, including bariatric Surgery, gastrointestinal surgery , hepatopancreatobiliary surgery, endocrine surgery, and minimally invasive surgery. He is affiliated with Methodist Hospital.

Dr. Reardon is a highly experienced doctor, with 32 years of practice in his field. He attended medical school, as well as completed his residency and fellowship, at the prestigious Baylor College of Medicine, and is currently certified by the American Board of Surgery. Also a Fellow of the American College of Surgeons , he is known in the community for his research studies.

He is highly regarded by his patients, who consistently give him high patient satisfaction rankings. He was voted a top MD by Consumers Checkbook, a SuperDoctor by Doctors.com, and has won a Vitals.com Patients Choice Award.

How Do I Strengthen My Acid Reflux Barrier

Holiday Heartburn

Grace from Houston sent us this question: Hi, I have reflux at night, and I am on a mixture of zinc, digestive enzymes, and slippery elm. This helped and I just was on zinc. But just recently it has flared up again, but with heartburn as well. I had reintroduced coffee and small amount of dark chocolate. I saw you have said food doesnt cause reflux. How do I strengthen the weak anti-reflux barrier, is this the sphincter and what if I have low stomach acid? I really appreciate your help, thank you.

Dear Grace,

The most reliable approach to strengthening acid reflux barrier is hiatal hernia repair and Nissen fundoplication. Laparoscopic hiatal hernia repair and Nissen fundoplication safely and effectively restores the anti-reflux barrier, leading to immediate cessation of acid reflux from stomach into esophagus. Following Hiatal hernia repair and Nissen fundoplication you can enjoy a regular diet including coffee and dark chocolate.

There are no medications or natural supplements that can strengthen or restore the anti-reflux barrier. Zinc, digestive enzymes, and an endless number of folk remedies do not address the complex underlying pathophysiology of acid reflux.

Furthermore, certain exercises, stretching techniques and chiropractic adjustments do not strengthen or restore the anti-reflux barrier. Hiatal hernia repair can only be achieved through surgery. There is no musculoskeletal maneuver that can reverse a hiatal hernia or strengthen the anti-reflux valve.

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What Is Acid Reflux

Acid reflux occurs when digestive acid escapes from your stomach and travels up your esophagus. The more delicate tissues lining the esophagus can’t tolerate the strength of the acid and become inflamed and painful.

The acid can get out of your stomach if the lower esophageal sphincter or LES at the bottom of your esophagus isn’t functioning correctly. The LES opens when you swallow, then forms a seal to stop anything coming out. If it’s weak or damaged, acid can flow back up your esophagus.

The classic symptom of acid reflux is heartburn, a deeply uncomfortable burning pain in the center of your chest. While occasional acid reflux isn’t a problem, repeated attacks lead to gastroesophageal reflux disease . Longer-term, GERD can develop into Barrett’s esophagus, which increases your risk of getting esophageal cancer.

Why Would I Need Acid Reflux Surgery

Acid reflux surgery is an option that may be necessary if other treatments aren’t helping relieve your symptoms.

For most patients, changing what and when they eat, quitting smoking, losing weight, or avoiding foods or drinks that trigger an acid reflux attack is sufficient to resolve the problem.

In addition to these lifestyle changes, patients with chronic problems like GERD can benefit from taking medications. For example, H2 receptor blockers and proton pump inhibitors can help by reducing acid production.

If your symptoms still don’t improve, there are several forms of acid reflux surgery that the team at GI Specialists of Houston, LLP, can perform.

Also Check: What To Take To Get Rid Of Heartburn

Meet Doctor Sheilendra Suresh Mehta Md Facs

Dr. Sheilendra Suresh Mehta is an experienced board certified surgeon with Texas Laparoscopic Consultants in Houston, and is also the Medical Director of the Bariatric Surgery Program at Memorial Hermann Sugarland Hospital. Dr. Mehta specializes in minimally invasive surgical techniques, and is committed to providing comprehensive patient care. Dr. Mehta holds a chemistry degree from Texas Tech University and earned his medical degree from University of Texas Health Medical School at Houston McGovern Medical School. He received several awards during his internship and residency at Staten Island University Hospital and completed fellowship training at The Methodist Hospital in Houston. He has also conducted and published extensive research on acid reflux treatment. Dr. Mehta is dedicated to helping patients find relief from GERD so they can live healthier lives.

How Long Does Linx Surgery Last

Check This Out

Steve from Austin, TX sent us this question: I had the LINX procedure about 5 years ago. Im a singer. The first 4 years everything was awesome. Now suddenly I literally cant go one night without reflux no matter what. Ive tried everything recently with zero results. Im wondering if something happened with the LINX.

Dear Steve,

Like any mechanical device, LINX device may break down over time. A simple X-ray study can detect device failure. LINX device may also migrate up into the chest or erode into the esophagus leading to recurrent acid reflux symptoms like heartburn, hoarseness, sore throat and voice fatigue.

A potential long-term complication of LINX surgery is related to esophageal failure. LINX device creates a high pressure and low compliance zone around the lower esophageal sphincter. In addition to scar tissue formation, the bracelet of magnetic beads results in a barrier against food bolus movement during swallowing. Initially, a healthy esophagus overcomes this barrier. Overtime, however, esophageal contractions may start to weaken leading to esophageal failure, dysphagia, and development of acid reflux related symptoms. Heartburn may be the first presenting symptom. Evaluation consists of esophageal manometry, and UGI contrast study. Treatment relies on LINX device removal and conversion to a floppy and short Nissen or Toupet fundoplication.

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