A procedure that can relieve severe heartburn is now offered by the NHS.
The 60-minute surgery, which involves implanting a golf ball-sized silicone ball into the stomach, can dramatically reduce the burning pain caused when stomach acid leaks back into the throat.
Around one in four people in the UK regularly suffer from heartburn, also known as acid reflux or – in more severe cases – gastro-oesophageal reflux disease (GERD). It can be caused by eating certain foods and over time, the damage to the esophagus from rising stomach acid can lead to serious complications ranging from swallowing problems to cancer.
The device, RefluxStop, was previously only available privately and cost £12,000. It relieves the problem by applying gentle pressure to the faulty valve at the top of the stomach to prevent the acid from escaping.
A £12,000 operation could offer hope to thousands of Britons suffering from severe acid reflux problems
In the most severe cases, acid reflux can lead to permanent damage and even cancer
It is a revolutionary option for the most severely affected patients who have difficulty swallowing. Six of them have now successfully undergone the keyhole procedure on the NHS at St Mary's Hospital in London, and other hospitals are said to be planning to introduce the operation next year.
A trial is also being planned to prove its effectiveness to the NHS treatment watchdog, the National Institute for Health and Care Excellence (NICE), in the hope that RefluxStop could become a standard treatment option for struggling patients.
One of the first to receive the device from the NHS was Jeff Cohen, 45, from London, who has struggled with GORD since his teens.
The damage to his esophagus from the rising stomach acid had become so severe that he could not eat more than a few bites of food at a time. He managed the condition with medications called proton pump inhibitors, or PPIs, which reduce the production of stomach acid. But these no longer worked properly.
'For the past five years I have had problems with eating; it felt like the food wasn't being digested properly, causing acid to come up. Around 5 p.m. I felt I couldn't swallow anymore,” he says. 'For the last few years, I find it very uncomfortable to eat a meal. It was also difficult mentally because I wanted to socialize but I didn't feel comfortable going outside because I didn't know how much pain I was going to be in.'
Jeff was referred to St Mary's and underwent the procedure in September.
He says: 'The problems I had with acid reflux have completely disappeared. I could see on scans that there is minimal acid coming up now, which is a relief. I haven't taken a tablet since the day before my operation. Sometimes I feel it, but it doesn't bother me anymore.'
Most often, acid reflux is caused by a weakness or defect in the lower esophageal sphincter – a valve at the top of the stomach that allows food to pass. When it doesn't close properly, stomach acid flows back into the esophagus, causing pain and further damaging the valve.
It is more common in people over 40 years of age and can be made worse by being overweight, because being overweight puts extra pressure on the stomach, forcing the acid up. Spicy foods, citrus fruits, alcohol and smoking can also cause symptoms, and – along with the pain – the problem can lead to insomnia, tooth damage, nutritional deficiencies and depression.
For most people, it can be controlled by taking over-the-counter antacids such as Gaviscon, avoiding trigger foods, and losing weight. Others need to take proton pump inhibitors, but many don't want to take lifelong medications, and the medications can have serious side effects, including bone weakness and kidney problems.
Before RefluxStop, two operations were possible. Fundoplication involves suturing part of the stomach around the esophagus to tighten the sphincter, and LINX involves inserting a magnetic device around the same valve. But both can cause further swallowing problems.
During the RefluxStop procedure, a silicone ball is placed in a bag in the stomach wall. This puts gentle pressure on the esophageal sphincter to keep it closed, but not enough to restrict swallowing.
Mr Ahmed Ahmed, a gastrointestinal surgeon at Imperial College Healthcare NHS Trust who carried out the NHS operations, said RefluxStop was a 'really good option' for those who did not want to take medication or who were not suitable for the other procedures. . “For these patients, continuing to take PPI medications is not always a suitable option,” he says. 'These drugs can become ineffective and because they are often taken in high doses, studies have linked them to bone weakness, kidney disease and a higher risk of stomach cancer.
'Some patients – possibly half of those with GERD – have such severe reflux that they cannot undergo the other operations because they have poor esophageal motility, meaning the muscle that normally pushes food into the stomach does not work properly.
'Existing surgeries can make this worse, making them traditionally difficult to treat.
“It's very exciting that we now have a way to treat these patients, but ultimately it would work for everyone.”