New pro­ce­dure re­duces acid re­flux

The News-Times - - ADVICE/GAMES - Keith Roach, M.D.

Dear Dr. Roach: I am a 78-year-old fe­male who has suf­fered from acid re­flux for many years and has been tak­ing Prilosec (omepra­zole) for at least 15 years. I have heard that it is not meant for long­time use. If I don’t take it, I have such heartburn I can’t sleep and am in mis­ery all day and night. I re­cently at­tended a sem­i­nar on the new LINX surgery and hope to have it done.

Do you have any in­for­ma­tion on the suc­cess or prob­lems af­ter this surgery?

J.B.

An­swer: The LINX de­vice is a mag­netic ring, placed by la­paro­scopic surgery, that helps in­crease the strength of the lower esophageal sphinc­ter, the valve-like mus­cu­lar struc­ture at the junc­tion of the esoph­a­gus and the stom­ach.

This re­duces re­flux (back­ward move­ment) of stom­ach acid up into the esoph­a­gus. The pro­ce­dure was very ef­fec­tive at re­duc­ing both heartburn symp­toms (89% be­fore pro­ce­dure to 12% af­ter) and the need for daily medicines like omepra­zole (100% be­fore to 15% af­ter).

The de­vice has not been in use for a very long time, so long-term safety data is un­avail­able. Some peo­ple had to have the de­vices re­moved be­cause they eroded into the esoph­a­gus, but only 0.3% of de­vices were re­moved at four years.

There are other types of surg­eries used to treat re­flux, most of which are ef­fec­tive at re­duc­ing both symp­toms and the need for med­i­ca­tion.

There are now op­tions for treat­ment be­ing done en­do­scop­i­cally (with an in­stru­ment placed through the mouth), with­out the need even for la­paro­scopic surgery (with the in­stru­ment be­ing placed by small in­ci­sions through the skin).

My per­sonal prac­tice is to dis­cuss med­i­ca­tion treat­ments as well as sur­gi­cal treat­ments for peo­ple with mod­er­ate to se­vere acid re­flux.

Surgery in younger peo­ple may have more ben­e­fit by pre­vent­ing a life­time of daily med­i­ca­tion. Peo­ple who do not get re­lief with med­i­ca­tion are those who most clearly ben­e­fit from these kinds of pro­ce­dures.

Dear Dr. Roach: I am a 90-year-old man. My wife’s life was saved in 1952 with Red Cross blood. Since then, I have do­nated more than 31 gal­lons of blood. My blood is CMV neg­a­tive. They want me to do­nate more.

I had a CT scan af­ter a fall, and a 1 cm ground-glass nod­ule was found in my lung. They are go­ing to do an­other scan in six months to see if it is grow­ing. The Red Cross said if I had cancer I should re­frain from do­nat­ing. What should I do?

J.J.B.

An­swer: Based on the in­for­ma­tion you are giv­ing me, it’s about 90% likely that this will not be cancer. A repeat scan to see if it is grow­ing is a good idea.

Even in the un­likely event this is cancer, the like­li­hood of pass­ing cancer cells along in a blood trans­fu­sion is very, very small.

How­ever, blood banks like the Red Cross are ex­ceed­ingly care­ful to main­tain a safe blood sup­ply, and wait­ing six months to do­nate is safest.

Let me add my thanks to your self­less giv­ing of a pre­cious, life-sav­ing re­source — your blood — which is es­pe­cially valu­able to peo­ple with im­mune sys­tem dis­ease given the lack of the com­mon pathogen cy­tomegalovi­rus, which can cause se­ri­ous dis­ease in peo­ple af­ter cancer chemo­ther­apy.

Read­ers may email ques­tions to: ToYourGood­[email protected] .cor­nell.edu or mail ques­tions to 628 Vir­ginia Dr., Or­lando, FL 32803.

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