Many of us have felt the familiar burn in our chest after over-indulging on a heavy meal, or the occasional night-time indigestion. But for many, severe reflux and heartburn caused by gastro-oesophageal reflux disease (‘GORD’) is misery. Though there are treatments available for mild-to-moderate reflux, gastritis and heartburn, many of these have been around for decades and there has been little advancement in this area of gastroenterology. However, a team at University Hospital Southampton have just recently completed the UK’s first procedures involving a novel device that promises to bring much needed relief to many people across the nation with severe GORD.
GORD, also known as GERD in the U.S., is a disease where a faulty “valve” (the lower oesophageal sphincter), which should hold the oesophagus closed when you’re not swallowing, does not close properly. The oesophagus is the tube that transports food from the throat to the stomach; if the lower sphincter remains open, the contents of the stomach, stomach acid included, is able to flow back up and damage the lining of the oesophagus. Reflux after a meal once in a while is nothing to be concerned about, but the regular reflux seen in GORD causes recurrent damage and results in chronic heartburn, difficulty and pain when swallowing, tooth erosion, coughing, and other frustrating symptoms – and can progressively increase the risk of cancer.
Current treatments involve lifestyle moderation, antacid medications for mild symptoms (like Gaviscon), then more intensive treatments such as “proton pump inhibitor” medication, namely omeprazole and lansoprazole. These medicines reduce the production of stomach acid and were originally developed to take short-term, to allow an ulcer or inflammation of the stomach or oesophagus to heal. However, many GORD patients have been left on these medications for life, which increases the risk of side-effects such as nutrient deficiencies and certain types of infection.
Though treatments to help close the lower oesophageal sphincter have been used in the U.S. for some time, none have been available in the UK until recently. This “revolutionary” new device, named “RefluxStop”, is set to change that.
The RefluxStop device is implanted into the upper part of the stomach wall and prevents the lower oesophageal sphincter from moving out of position (such as due to muscle weakness), holding it in its original position and restoring normal anatomy and function. “Made out of medical grade rounded solid silicone, the implant measures around 25mm – smaller than a ping pong ball – and is fitted via robotic-assisted laparoscopic (keyhole) surgery as a day case, with patients in theatre for less than two hours”, a spokesperson for the hospital has said.
It is a very welcome change to treatment, as many procedures in the UK have until recently involved more invasive surgeries and were performed for only the sickest GORD patients at high risk of cancer due to permanent and severe damage to their oesophagus (“Barrett’s Oesophagus”). These procedures include fundoplication, which involves wrapping the stomach around the oesophagus to reinforce the lower sphincter and help prevent reflux. This is a major surgery and involves a high amount of risk, with serious complications possible and even the chance of coming undone over time - quite unlike the novel technique at UHS.
The early success of RefluxStop, then, looks to be a step in the right direction for people with GORD and promises to greatly improve quality of life for many. While we’ll need to continue to monitor outcomes in the long-term, hopefully patients across the UK can look forward to a more accessible, less harsh treatment option with lasting alleviation of their symptoms – and even more innovation in this field, leading to a full and permanent cure for this disease – in the near future.