Checkup

Dousing the flame: Injectable implant eases chronic heartburn

Serious, chronic heartburn leaves sufferers with few choices: take medication every day or consider surgery. But a new, nonsurgical outpatient procedure offers a safe alternative for many patients.

The procedure involves injecting a sponge-like substance into the lower esophageal sphincter, the muscle that acts like a valve to help keep stomach acid from flowing back into the food pipe. People who suffer from gastroesophageal reflux disease (GERD) often have a weak esophageal sphincter, which lets stomach acid flow back into the esophagus.

"Injecting this substance bulks up the sphincter, creating a permanent implant, and decreases influx," says gastroenterologist Dr. David Loeb. "This is another option if you don't want surgery. The latest data on this procedure are very encouraging."

One trial showed that 70 percent of patients who had the procedure eliminated their dependence on daily medication, and another 10 percent were able to cut their medications in half.

The procedure is done on an outpatient basis. Patients are sedated, and the gastroenterologist passes an endoscope (a narrow tube with a tiny camera on the end) through the patient's mouth and into the esophagus to locate the injection site. A small catheter with a needle on the end is then passed through the endoscope, and the liquid copolymer is injected. Special X-ray equipment called a fluoroscope will show the doctor where the substance is injected. The procedure takes less than an hour.

Some patients may have temporary chest pain or difficulty swallowing after the procedure, but side effects are usually manageable and short-lived.

"There have been no major problems such as bleeding or perforation," Loeb says. "This seems like a safe treatment with long-term benefit. It's somewhere between taking medications forever and having surgery."

The procedure is not for patients with large hiatal hernias or those who have distended veins (varices) in the esophagus.

Info:
Division of Gastroenterology & Hepatology
(904) 953-0816