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University Hospital announces new treatment for GERD

SYRACUSE, N.Y.-University Hospital is now offering the Plicator procedure, a new treatment option for individuals who are dependent on medications or who would otherwise need surgery to control symptoms of heartburn and gastroesophageal reflux disease (GERD). The procedure, performed on an outpatient basis at University Hospital, has been shown to reduce or completely eliminate symptoms and medication use associated with GERD.

University Hospital is the only hospital in New York State, outside the New York City metropolitan area, to offer the procedure. It is performed by University Hospital gastroenterologists Ronald Szyjkowski, M.D., and Bipin Saud, M.D. The Plicator was developed and is marketed by NDO Surgical Inc., a privately held company based in Mansfield, Mass.

According to Szyjkowski, a muscular valve at the end of the esophagus called the lower esophageal sphincter, normally keeps stomach contents from flowing up into the esophagus. However, in someone with GERD this valve is weak or relaxes too frequently, allowing stomach contents to flow freely into the esophagus. The Plicator procedure corrects this underlying mechanical defect that causes GERD.

"Reflux can be a very debilitating condition and this procedure gives patients a viable alternative to long-term drug use or anti-reflux surgery," said Szyjkowski.

The Plicator is a flexible endoscopic instrument that is inserted through the mouth, down the esophagus and into the stomach where it is positioned at the gastroesophageal junction. The Plicator then grasps, folds and fixates tissue at this junction by using standard suture, tightening the valve that restores the normal anti-reflux barrier. The entire procedure is visualized through the scope's high-resolution cameras, allowing for precise suture placement.

The procedure is performed under conscious sedation in an outpatient setting, typically in 30 minutes or less and allows patients to return home the same day. In a multi-center trial, the Plicator procedure was effective at one-year post-procedure in eliminating the need for prescription heartburn medications in 70 percent of treated patients.

Prior to the Plicator procedure, treatment options for GERD were limited to chronic drug therapy or traditional anti-reflux surgery. "While daily intake of medications known as proton pump inhibitors is safe and can provide significant symptom relief for most patients, they help only to suppress acid production and do not prevent the physical regurgitation of gastric contents into the esophagus," said Szyjkowski. "In addition, the drugs are often required for a patient's lifetime since GERD symptoms will typically return once medication has been discontinued or forgotten. Many patients do not want to take medicine everyday and until now, surgery was their only other option."

Traditional anti-reflux surgery requires general anesthesia, multiple incisions, hospitalization and a recovery period lasting several days.

An estimated 15 million people in the United States suffer from GERD, making it the most prevalent disorder of the esophagus. The most common symptom of GERD is heartburn, described by sufferers as a burning sensation behind the breastbone. Other symptoms include regurgitation, chest pain, hoarseness, wheezing, and chronic cough.

Left untreated, GERD can lead to a variety of serious esophageal complications including inflammation, also known as esophagitis; ulceration; or strictures. GERD patients are at risk to develop a pre-cancerous condition known as Barrett's esophagus. To qualify for the procedure, patients must be aged 18 years or over, diagnosed with GERD by their physician and should have completed a trial of antacid medicines.

Most insurance companies cover the procedure. Patients may be referred by a physician or may self-refer.

For more information or to schedule an appointment, call Dixie Janicek at 315-464-5804.