Colleen, a retired sales manager, had suffered from heartburn and laryngitis for years, which she attributed to seasonal allergies and frequent airplane travel for work. To manage her symptoms, she tried a variety of medications and avoided certain foods known to cause indigestion.
As her symptoms intensified, including a bout of laryngitis for over 100 days, they kept her from doing the things she loved, like mat Pilates and playing golf, as she feared a reflux flare-up. Colleen began to suspect there was a correlation between her worsening laryngitis and her heartburn. She knew she needed to find answers and a permanent resolution.
Searching for Answers
After a round of tests, Colleen was officially diagnosed with two digestive disorders: gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LRPD). GERD occurs when acid from the stomach repeatedly refluxes or flows into the esophagus, which connects the throat with the stomach. Heartburn is the most common symptom of GERD. LPRD is an inflammatory reaction caused by acid traveling up the esophagus into the throat or voice box, called the larynx.
Colleen researched multiple treatment options, including an acid reflux surgery (laparoscopic fundoplication) that is performed through incisions in the abdomen. Though it had the potential to resolve some of her symptoms, it is an invasive surgery that her gastroenterologist felt could be avoided in her case.
At that point, she was referred to Christopher Morse, MD, co-director of the Gastroesophageal Surgery Program at Massachusetts General Hospital, who recommended her as a candidate for a TIF procedure.
There is no doubt that every 't' was crossed and every 'i' dotted.
What Is TIF?
Transoral Incisionless Fundoplication (TIF) is a minimally invasive procedure used to treat GERD without the incisions or lengthy recovery time. The procedure reconstructs the valve at the top of the stomach to prevent abnormal acid reflux. The valve is created by folding the stomach tissue and is then secured with tissue fasteners. Although the procedure is performed under general anesthesia, the instrument that creates the valve is introduced through the mouth, so there are no incisions. You are eligible for the procedure if you have documented GERD, do not have a hiatal hernia (when the upper part of the stomach bulges through the diaphragm) and have a body mass index less than 35.
At Mass General, the TIF procedure program is multidisciplinary and offers coordination between various departments, to get the best possible outcomes for patients like Colleen.
Personalized, Supportive Care
When Colleen met Dr. Morse, he agreed that her specific symptoms did not require acid reflux surgery and could be alleviated with the minimally-invasive TIF procedure. Colleen had this procedure performed by Dr. Morse in 2018.
Colleen had an immediate rapport with Dr. Morse and felt he prepared her very well for what her TIF procedure would entail and helped her manage her expectations.
"Dr. Morse was very honest about the surgery and felt that it should be very effective in relieving my symptoms, but not necessarily eliminating them," she says. "And Julie Garrity, RN, was very thorough in scheduling my surgery and making sure that I had all of the information that I needed. There is no doubt that every 't' was crossed and every 'i' dotted."
She appreciated the professionalism of her Mass General team and also their friendliness and ability to put her at ease.
Relief at Last
Colleen's surgery and treatment "went off without a hitch," and she felt great as soon as the next day, she says, even if the clear liquid diet for the first week after surgery was challenging.
For the weeks following her surgery, she followed a soft diet, avoided strenuous activity and met with the care team for a follow-up appointment two weeks later to monitor her progress. Colleen says there were no surprises during her experience and she knew what to expect for every step of the process.
Today, she feels great, and while she still has to stay away from certain foods, she no longer has to take daily medication to relieve her reflux symptoms. The fact that it is no longer chronic is a big relief, she says. And, most importantly, she has been able to get back to enjoying her retirement by doing the physical activities she loves!
Digestive Healthcare at Mass General
The Massachusetts General Hospital Digestive Healthcare Center is a collaborative practice of gastroenterologists, endoscopists, surgeons, radiologists, pathologists, hepatologists, oncologists and radiation oncologists dedicated to the prevention, diagnosis, treatment and management of digestive diseases.