By: Jean Johnson for Reflux1Patients with severe gastroesophageal reflux disease (GERD) who do not respond to conventional therapies can leave their physicians stymied. That’s why specialists in the field of GERD – or acid reflux – have resorted to technology that takes 24-hour measurements of pH conditions in the esophagus. This technology allows them to tell more precisely what is going on in the nether regions of the gullet.
The only problem is that the device, which is placed via a catheter and runs up through the nose and then down the throat and into the esophagus, is not especially comfortable for patients to endure throughout the day and night it needs to stay in place.
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The main symptoms of GERD are:
Heartburn or an uncomfortable, rising, burning sensation behind the breastbone.
Regurgitation of gastric acid or sour contents into the mouth
Difficult or painful swallowing
Chest pain that can sometimes be confused with a heart attack |
Indeed, the intrepid group that leaves the doctor’s office to resume relatively normal activities report disliking the contraption that’s affixed to their person. Not only is it visible at the nose where it’s anchored, but patients report pain and discomfort in their nose and throat regions as well. Wireless Capsule Circumvents the Need for Uncomfortable Catheters
Enter the world of wireless technology. AstraZeneca, an international pharmaceutical and healthcare technology corporation, has developed a system that is temporarily attached to the sphincter between the lower esophagus and stomach. It takes the place of a gastroenterologist by measuring the pH needed to treat hard-to-manage cases, and does so without the use of a catheter.
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The following lifestyle changes may help in reducing the frequency of heartburn:
Control your weight. Being overweight is one of the strongest risk factors for heartburn. Excess pounds put pressure on your abdomen, pushing your stomach upward and causing acid to back up into your esophagus.
Eat smaller meals. Putting less stress on the stomach in turn reduces pressure on the lower esophageal sphincter. This enables the valve to stay closed, preventing acid from washing back into your esophagus.
Loosen your belt. Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter.
Eliminate heartburn triggers. Know what foods or substances tend to trigger heartburn episodes. Fatty or fried foods, alcohol, chocolate, peppermint, garlic, onion, caffeine, and nicotine may make heartburn worse.
Avoid stooping or bending for extended times. Briefly bending over to tie your shoes is fine, but doing things like gardening that keep you bent over for prolonged periods can be a problem especially directly after eating.
Don't lie down after a meal. Try a walk instead, or at the very least sit in a chair instead of lying on the couch. Try to wait at least three to four hours after eating before going to bed.
Raise the head of your bed six to nine inches. Place wooden blocks under the feet at the head of the bed or purchase a foam wedge to insert between the mattress and springs. Wedges are available at drugstores and medical supply stores. Raising your head by using pillows only is not a good alternative.
Don't smoke. Smoking may increase stomach acid. The swallowing of air during smoking may also aggravate belching and acid reflux. In addition, smoking and alcohol increase your risk of esophageal cancer. |
“You’re talking about a device that’s kind of unsightly for the day that you are using it, and it’s definitely irritating to your sinuses and your nose,” David Mark, M.D., associate director of the Blue Cross and Blue Shield Association’s Technology Evaluation Center where the new system was tested, and lead author in a review of the new technology, told Medical News Today about the old catheter-drive method for collecting pH data. Mark’s team reviewed nine published studies that investigated the use of both the wireless and catheter-attached devices. That said, everything has its limitations, and patients can feel the wireless implant within their chests. “So you are trading 80 to 90 percent chance of nose pain and throat discomfort for about a 30 to 40 percent chance of having some discomfort behind your sternum,” said Mark.
Wireless GERD Monitor More Comfortable and Just As Reliable
In addition to the encouraging odds on the patient comfort front, AstraZeneca’s wireless device monitors pH conditions as efficiently as the older device that is connected to a catheter. Not only does the wireless monitor generally remain in place throughout the 24-hour period, the study showed that it can stay where it was placed for as long as 48 hours. Some think that might be a good thing.
“It takes training and experience to interpret the physiological data. Traditionally physicians have had 20 hours worth of data to interpret,” gastroenterologist Jed Weissberg, M.D., a physician-consultant who commented on the review of the evidence told Medical News Today. “With the wireless capsule, there is the possibility of having more extended data collection. That’s an intriguing extension to the technique, though its impact on clinical management has not yet been carefully studied.”
For his part, Mark seems to think that the 24-hour window provides as much information as can be expected from a test like this: “After our survey of all the ways this wireless device has been studied, basically we can conclude that it was more comfortable than the wired device, that the diagnostic capacity of the wired and wireless devices seem to be similar, and that there’s no evidence that 48 hours was better than 24 hours,” he told Medical News Today.
Patients Favor More Comfortable Wireless Approach to Testing
The study review confirms that patients appreciate the wireless method of studying the pH in their esophagus. Dorothy Read of Portland, Oregon says that she would definitely choose the wireless option if her reflux ever deteriorated to a point where her physician suggested this kind of test.
“I can’t imagine walking around with a tube sticking out of my nose. I imagine they tape it into place, but oh, how awful it must be. And the idea of having it running down through your throat is enough to make me gag,” Read said. “I know because I’ve had some of those endoscopy tests and even though they gave me something, I really didn’t appreciate the procedure at all.
“So this wireless thing sounds like a good idea to me. Something that’s much more sensitive to a patient’s feelings,” Read added. “I’m glad the doctors – or whoever figured it out – are starting to consider those things a bit more than they seem to have in the past.”
Quick Stats on GERD
About seven million people in the United States alone suffer from GERD, and between 5 and 7 percent of the global population has GERD. GERD afflicts people of every socioeconomic class, ethnic group, and age.
GERD is most common in people over 45 of age, although anyone – even infants – can get GERD. However, more than half of those with GERD are between the ages of 45 and 64. GERD is a chronic disease and if not treated can lead to more severe problems including esophageal cancer.
