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Treatment of GERD with non-surgical TIF

Transoral Incisionless Fundoplication, or TIF, is an alternative non-surgical GERD treatment. A device is inserted through the mouth and the procedure to recreate the esophageal sphincter is performed from within.

How is TIF treated?
First, the patient is anesthetized. Then, a flexible endoscope is inserted through the mouth into the esophagus and guided into the stomach. After it is maneuvered to give a 180-degree bend providing a visualization of the tip of the esophagus that connects to the stomach, the specialist then uses the tool to pull the esophageal tissue, folding it into the device, wrapping the upper portion of the stomach around 270 degrees of the esophagus, tightening the sphincter to prevent the acid reflux. 

 
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  • Non-surgical and incisionless, so no scar 
  • Only overnight stay in hospital
  • Faster recovery than from surgery
  • Very safe, with less chance of complications
  • Procedure is repeatable if the reflux returns.
  • Those with GERD problems and non-responsive to medication treatment
  • Those affected by antacid side effects such as risk of fragile bones, certain types of gastrointestinal infections, and kidney or electrolyte abnormalities
  • Those trying to avoid long-term use of antacids for fear of side effects in the long run
  • Those having had GERD surgery treatment and the acid reflux returns 
  • Those with GERD but without other esophageal diseases such as motility disorder
For patients with a hiatal hernia larger than two centimeters, concomitant surgery for hernia repair is necessary before the TIF is performed to prevent acid reflux.

Some patients may experience the following side effects:

  • sore throat
  • shoulder pain
  • slight discomfort in the chest
  • slight bleeding
  • Stop taking anti-clotting medications such as aspirin for at least seven days, 
  • Stop using supplements and herbal medicines containing vitamin E, anti-inflammatory painkillers, Ginkgo biloba, garlic, or St. John's Wort for at least 10 days.
  • No smoking or drinking alcohol for at least 48 hours
  • No food or drinks 12 hours before the procedure
  • Resume work in 3-7 days.
  • Follow the doctor's diet recommendations for the first 6-12 weeks. For example, it’s better to have 4-5 small light soft meals a day and to avoid fibrous foods like nuts and vegetables, spicy foods, too hot or too cold drinks, and acidic or fatty foods causing gas in the stomach.
  • If you have flatulence, take anti-flatulent medication but do not force yourself to burp.
  • Avoid vomiting or coughing.
  • Stop smoking.
  • Resume sex after seven days.
  • You can drive after 1-2 days, but you should not drive if taking painkillers or feeling tired.
  • You can exercise by walking, starting with a short walk and gradually increasing the distance.
  • No weight lifting of over 2.5 kg in the first 2 weeks and over 11 kg in the 3rd -6th weeks.

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