what should I expect from TIF?

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carolanno
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Date Joined Dec 2011
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   Posted 12/7/2011 1:05 PM (GMT -6)   
I'm about to have a TIF (transoral incisionless fundoplication).   I don't want the Nissen procedure because of the side effects.   I think I would be trading one pain for another.   From what I have read, the TIF procedure has fewer side effects/complications.   Has anyone had this operation?
 
I have had the upper G.I., the endoscopy with Bravo pH test, the stomach emptying study and lower bowel study.   I also have a small hiatal hernia.   I am worried sick I will have to have the mannometry test... is this manditory?
 
I would appreciate hearing from anyone who has had the TIF and their experience and what I might expect.   Thanks.

Post Edited (carolanno) : 12/7/2011 1:41:57 PM (GMT-7)


babygirl10150
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Date Joined Jul 2006
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   Posted 12/7/2011 1:44 PM (GMT -6)   
I did not have the TIF but I would get the manometry to make sure you don't have a motility problem before surgery. If you do, it can cause a bunch of problems after surgery. It's not a fun test at all but it's only an hour and can show a lot. Just have them numb your throat, it makes it much more tolerable. I've had it both ways, numb and not numb.
Michelle

~Diagnosed with POTS 10/11~
~Nissen redo #3 coming soon~
~Nissen redo again 12/13/10~
~Nissen redo 05/10/10~
~Nissen 12/14/09~
~Colostomy 07/30/06~

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/7/2011 2:00 PM (GMT -6)   
I had the TIF back in August.  The fact that you haven't been scheduled for a manometry before this type of procedure concerns me, more to the fact that your physician isn't necessarily being thorough rather than critical information the test may provide.  Manometry doesn't always provide conclusive results, as in my case -- it proved negative, although something is obviously weak in my LES.
 
In spite of this, I do agree with Michelle that you should have the test done, on the off-side chance that it could show something important.  You also didn't mention anything about biopsies...have you been checked for eosinophil counts?
 
Best of luck!
 
-Bruce
 
P.S.  You may want to edit your post and add a subject line so you can find it later to review your responses, and perhaps add something more.

aciphexo
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Date Joined Apr 2011
Total Posts : 377
   Posted 12/7/2011 3:37 PM (GMT -6)   
I've been doing some research on TIF myself (and am scheduled to see a surgeon later next month).

This is an insurance site and seems to claim that the TIF sutures don't hold too well in the long term:

blue.regence.com/trgmedpol/surgery/sur110.html

I'd appreciate comments on this from people who've had experience with TIF.

Thanks.

LocalGuy23
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Date Joined Sep 2011
Total Posts : 620
   Posted 12/7/2011 4:51 PM (GMT -6)   
PPI-LESS,

Do you LPR symptoms or just GERD symptoms?

carolanno
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Date Joined Dec 2011
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   Posted 12/7/2011 4:54 PM (GMT -6)   
I have acid reflux and stomach pains.   I also have a hiatal hernia.

LocalGuy23
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Date Joined Sep 2011
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   Posted 12/7/2011 5:14 PM (GMT -6)   
Can you describe your stomach pains? Is it a constant burning pain like gastritis. I have that too....I believe it was caused from the PPIs. It's like a 2 or 3 on a scale of 10. That's why I'm afraid of Nissen. I need to eat and drink constantly for the pain to be a constant 2-3. I hope with fixing the valve the stomach will heal.

Have you considered the LINX procedure?

carolanno
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Date Joined Dec 2011
Total Posts : 7
   Posted 12/7/2011 5:26 PM (GMT -6)   
The stomach pains come and go. I have also had gastritis 6 times, but the current pain comes and goes. I, too sometimes think the pains are caused by the Nexium, but I will go weeks without the pain. I am also taking Carafate and twice a day swallow a Mylanta cocktail, which really helps relieve the pain. I have been on Nexium for 10 years (2 x day, 40 mg.). The heartburn was relieved when I went on the 2 doses of Nexium, but returned last May. I have taken every PPI there is and Nexium was the only Rx that helped. I have never been totally without pain for 11 years. Either it's the heartburn or the stomach pains and painful bloating.

I thought the LINX procedure was only available in Europe???

LocalGuy23
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Date Joined Sep 2011
Total Posts : 620
   Posted 12/7/2011 5:28 PM (GMT -6)   
No, you can get it in Italy but it will be all out of pocket.....

I myself never had success with PPIs...all of them...I currently take 40mg Pepcid 2x a day. I'm not even sure if that helps.

That's why I want to take the next approach like you.....surgery.

We're just both afraid of Nissen ;) With good reason and looking at these alternative surgeries.

aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 12/7/2011 5:48 PM (GMT -6)   
My symptoms:

Feb11=> thick mucous in the throat, esophagus ache (no heartburn)
---PPIs/H2s started
Mar11=> Dysphagia, PPIs side effects started: knee-aches, depression, anxiety, insomnia
Apr=> Esophagus ache cleared. Throat symptoms remained. Side-effects on meds continued
---PPIs/H2s stopped after various experiments and combinations.
May/June/July11=>Severe throat symptoms (no heartburn).
---Experiemented with various other meds: gabapentin, antidepressants, benzos etc. Couldn't stay on them.
Aug/Sep/Oct11=>Throat symptoms subsided - heartburn symptoms started in chest + mouth.
Nov11-Present=>Heartburn symptoms (chest discomfort, warm / cool pain/aches around the LES, achiness in the throat, bitter taste in mouth). Frequency of symptoms reduced - sometimes I get a full day of relief. But, they promptly come back.

I've had 2 endoscopies (normal), 2 manometries (normal) and 2 ph tests (1 abnormal and 1 normal). Going for another pH test (dual impedance) end of this month.

Yes, I've done a lot of research on LINX. However, I am not comfortable with having a foreign object sitting on the soft tissue of the esophagus ... near the vagus nerve ... esp. when this procedure is so new. Looks like Nissen is the best time-tested solution. However, the possible side effects are quite scary. TIF seems like a good middle ground .. however, is fairly new and some studies claim it is not as durable as Nissen.

At this point though, my tests don't show enough evidence of reflux. 99.99% of the people with my level of symptoms do very well on the PPIs. So, I am an absolute outlier ("outlier within the outliers" is how one dr. described me) ... who has mild to moderate GERD but needs a heavy duty surgery to fix it.

I am a 42 year old male .. otherwise healthy (no other problems).

Thats my story so far ...

carolanno
New Member


Date Joined Dec 2011
Total Posts : 7
   Posted 12/7/2011 5:53 PM (GMT -6)   
I have you beat on endoscopies...I've had 5.   My main fear is the mannometry.   I'm absolutely scared to death.   If I request it, will they sedate me?

bowecho
Regular Member


Date Joined Nov 2011
Total Posts : 146
   Posted 12/7/2011 5:56 PM (GMT -6)   
I was a little scared about the manometry myself, but it really wasn't as bad as I expected. If you just close your eyes, it'll be over before too long. Its really when they first put it in that is uncomfortable. Once its in there and during the test it is not bad. I'd do it again tomorrow if I had to without any worry.

carolanno
New Member


Date Joined Dec 2011
Total Posts : 7
   Posted 12/7/2011 6:01 PM (GMT -6)   
Thanks, bowecho

aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 12/7/2011 6:03 PM (GMT -6)   
I was quite ok with the manometry as well .. not a big deal .. some throat gaggy feeling .. but it gets over fairly quickly. Pain that is not going to last beyond a short amount of time does not bother me ...

GERD on the other hand they say - is progressive and chronic. Now that scares me the most - esp. when I haven't figured out any cause and effect of these symptoms. I've tried several natural things .. some things help .. but nothing seems to fix it.

carolanno
New Member


Date Joined Dec 2011
Total Posts : 7
   Posted 12/7/2011 6:17 PM (GMT -6)   
PPI-LESS:
How long does the procedure take? You are right, GERD is progressive. The thing that is so frustrating is that for eleven years I had so many specialists tell me that surgery was not an option. I have played the game and taken every test, every PPI out there and now I have almost constant pain. It doesn't matter what I eat. Food itself is the culprit. I even, on occasion, have pain upon waking.

I never thought I would consider surgery, but I'm truly at my wits end. I have a lot of living to do and I want it without pain!

aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 12/7/2011 6:26 PM (GMT -6)   
Carolanno .. in my case the procedure didn't last more than 15-20 minutes. They give you a cup of water with a straw .. and you take several sips and swallow it when they tell you to .. and they measure the various signals from the peristalsis (which you can also view on the screen). In fact, I distracted myself by watching the graph on the screen!

babygirl10150
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Date Joined Jul 2006
Total Posts : 639
   Posted 12/7/2011 6:38 PM (GMT -6)   
The length of the test depends on how you do with the sipping. If you drink when they don't tell you to, they have to start over and it's hard to not swallow with a tube in your throat. I had to do 10 'perfect' sips in a row. But it's mind over matter. Just have to go to a happy place.
Michelle

~Diagnosed with POTS 10/11~
~Nissen redo #3 coming soon~
~Nissen redo again 12/13/10~
~Nissen redo 05/10/10~
~Nissen 12/14/09~
~Colostomy 07/30/06~

Ollie7
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Date Joined Nov 2011
Total Posts : 14
   Posted 12/7/2011 7:12 PM (GMT -6)   
I have similar background/history as PPI-LESS. I'm 45 and have been good for the most part on Prilosec for years, but it does seem to be progressing and when it's bad, it's BAD!  I've also recently have seen a surgeon and while the Nissen is an option, the TIF seems to be recommended by surgeon. I want this decision to be a no-brainer, and I really want to go with the less invasive TIF, but can't seem to pull the trigger.

aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 12/7/2011 8:06 PM (GMT -6)   
Hi Ollie,

Why does your surgeon recommend TIF over Nissen? Can you ask him/her about the durability of TIF vs. Nissen?

Thanks

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/7/2011 10:24 PM (GMT -6)   
Just thought I'd make a quick point -- the link PPI-LESS provided concerning studies of some newer reflux surgery methods (including the TIF), did mention from one study the loss of sutures. However, if you read more closely, the EndoCinch procedure was included in this, with no distinction between that and the TIF. From what I know, the EndoCinch procedure is no longer being done by reputable surgeons...presumably because of this issue. I know of no direct studies condemning the TIF.

-Bruce

carolanno
New Member


Date Joined Dec 2011
Total Posts : 7
   Posted 12/8/2011 8:48 AM (GMT -6)   
Bruce-
 
You are right.   Plus, the date was from 2001.   A lot has changed.   I just know that the TIF supposedly has fewer side effects (inability to belch, bloating, etc.)   Also, the TIF can be redone.   The Nissen procedure is "one shot" and the dr. had better get it right the first time.

babygirl10150
Veteran Member


Date Joined Jul 2006
Total Posts : 639
   Posted 12/8/2011 7:50 PM (GMT -6)   
The nissen is not a 'one shot' deal. I've had 3, first 2 were too loose. Fourth one coming soon. I am not anywhere near the normal case but it can be redone.
Michelle

~Diagnosed with POTS 10/11~
~Nissen redo #3 coming soon~
~Nissen redo again 12/13/10~
~Nissen redo 05/10/10~
~Nissen 12/14/09~
~Colostomy 07/30/06~

bowecho
Regular Member


Date Joined Nov 2011
Total Posts : 146
   Posted 12/8/2011 8:26 PM (GMT -6)   
This is what I have heard from my surgeon as well, its not a one shot. If its too loose, can be tightened, too tight, can be loosened or taken down completely.
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