BEATING THE BURN

Keeping stomach acid where it belongs can be tough.

When medications don’t yield results, invasive and complicated surgery may be needed to prevent the heartburn and regurgitation of fluid into the mouth common with gastroesophageal reflux disease.

“Most patients I see for surgery are having issues with waking up at night having fluid in their throat,” says Dr. Manfred Chiang, a surgeon at Ascension’s Elmbrook campus. “They are aspirating or choking. They have bad sinus issues and acid on their teeth causing erosion.”

Chiang says he’s the only physician in the Milwaukee area offering an innovative nonsurgical option: transoral incisionless fundoplication, or TIF.

The procedure, performed through the mouth, involves wrapping the upper portion of the stomach around the lower esophagus, preventing stomach acid from moving into the esophagus.

“There are no cuts in the abdomen and it can be done as an outpatient procedure,” Chiang explains during a break from seeing patients at an Ascension clinic in Brookfield.

Chiang estimates he has performed the procedure about 50 times since 2009. Cost has been a hindrance to patients, but some insurance providers in Wisconsin began covering the procedure earlier this year.

It’s an alternative to more invasive procedures and extended use of prescription medications, particularly proton pump inhibitors that Chiang notes have elicited concerns recently over their long-term use.