Britons at risk of cancer from severe heartburn are to be offered a scalpel-free procedure to cure the condition on the NHS.
The new 60-minute operation tightens the valve at the entrance to the stomach to prevent acid leaking out after eating – the main cause of heartburn symptoms such as chest pain and burning in the throat.
It will be given to patients with Barrett’s oesophagus, a condition that occurs when digestive acid damages the lining the oesophagus – the food pipe between the throat and stomach – which triggers pre-cancerous changes in affected tissue and even cancer itself.
Traditional treatment involves removing the damaged tissue, but the heartburn problems remain.
Britons at risk of cancer from severe heartburn are to be offered a scalpel-free procedure to cure the condition on the NHS (stock photo)
Now NHS chiefs have given the green light to a procedure, called transoral incisionless fundoplication (TIF), that in most cases ends acid reflux for good. Trials have shown nearly nine out of ten patients are free from heartburn symptoms three years later.
Dr Rehan Haidry, consultant gastroenterologist at University College London Hospital and the first doctor in the UK to carry out the surgery, said: ‘The benefit of this procedure is two-fold.
‘It reduces your risk of cancer and increases your quality of life, because you’re no longer living with uncomfortable symptoms. This is big step forwards for NHS patients.’
Chronic heartburn, known as gastro-oesophageal reflux disease, or GORD, affects one in five Britons. It is often triggered by overeating, smoking or stress, and can also lead to a constant cough and hoarse voice. Left untreated, about 15 per cent of sufferers will develop Barrett’s oesophagus.
The new 60-minute operation tightens the valve at the entrance to the stomach to prevent acid leaking out after eating – the main cause of heartburn symptoms such as chest pain and burning in the throat
Proton pump inhibitors (PPIs), the drugs commonly prescribed to tackle acid reflux, are designed to stop the stomach producing too much acid but are ineffective in many cases.
‘You have people who’ve been taking PPIs for years with no real control of their condition,’ said Dr Haidry. ‘These people are still chomping down on Rennie [heartburn] tablets every night.’
Patients might be offered radiofrequency ablation, where a tube is inserted down their throat and the damaged tissue is burned away. However, Dr Haidry said: ‘Ablation doesn’t fix the underlying problem, which is the acid reflux.’
Traditionally, the next step was keyhole surgery. Surgeons make several incisions in the abdomen and then tie the upper part of the stomach around the bottom of the oesophagus, effectively tightening the faulty valve and stopping acid from flowing upwards.
Dr Rehan Haidry, consultant gastroenterologist at University College London Hospital and the first doctor in the UK to carry out the surgery, said: ‘This is big step forwards for NHS patients’
However, side-effects include issues swallowing, bloating and excessive burping. What’s more, about a third of patients still need to use PPIs.
The newly available treatment does not require any incisions and leads to fewer side effects. Instead, doctors put a surgical stitching tool, called an EsophyX, down the patient’s throat and make 20 tiny stitches on tissue at the bottom of the oesophagus.
This creates a new valve and reduces the amount of acid which can get through.
The operation is done under general anaesthetic and can be completed in under an hour – and patients do not even need to stay in hospital overnight.
One patient to benefit from the TIF procedure was Rachel Furse, 57, from St Austell in Cornwall, who suffered with GORD for more than 30 years.
She said: ‘Over the years I’ve had endoscopies, colonoscopies and seen many doctors and consultants, privately and on the NHS. It got to the point where I’d been given every PPI medication they could prescribe.
‘Nothing helped and I kept waking up in the night with reflux. My stomach was constantly bloated and the pain was not good.’
Rachel, who runs a company which sells healthcare products to the nursing and care industry, said her symptoms had worsened in recent years until a visit to a doctor in 2020 confirmed she had developed Barrett’s oesophagus.
While she suffered from a number of side effects after the surgery, including pain, nausea and diarrhoea, Rachel said her GORD has significantly reduced. She added: ‘I feel great and I’m so pleased I had the procedure. It really has changed my life so much for the better.
‘I now wake up with no stomach pains and I can sleep normally.’
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