SHM Converge Scientific Abstract ePoster Gallery-Transoral Incisionless Fundoplication (Tif) for Refractory Gastroesophageal Reflux Disease: A Case Report

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This case report describes the use of transoral incisionless fundoplication (TIF) as an alternative treatment for refractory gastroesophageal reflux disease (GERD). GERD is a chronic condition caused by reflux of gastric contents into the esophagus, producing symptoms such as heartburn and regurgitation. Standard treatment includes lifestyle modification and acid-suppressing medications such as proton pump inhibitors (PPIs), but some patients continue to have persistent symptoms despite therapy.<br /><br />TIF is a minimally invasive endoscopic procedure performed with the EsophyX device. It creates an esophagogastric fundoplication to improve the anti-reflux barrier and reduce acid exposure. It may be considered for patients whose GERD remains uncontrolled with medication, who do not have severe esophageal motility disorders, and who have a small or absent hiatal hernia. Compared with chronic medication use, TIF may reduce medication burden, costs, and long-term adverse effects.<br /><br />The patient in this report was a 48-year-old woman with a 5-year history of severe heartburn, regurgitation, and nocturnal symptoms. She had tried high-dose PPI therapy twice and then used omeprazole 20 mg for 3 years with minimal improvement. Evaluation with EGD showed a small hiatal hernia and grade C esophagitis, and 24-hour pH monitoring confirmed abnormal acid exposure. She underwent TIF and had follow-up at 1, 3, and 6 months showing marked symptom improvement, normalized acid exposure, and resolution of esophagitis.<br /><br />Overall, the report supports TIF as a safe, effective, less invasive option for selected patients with refractory GERD, though larger studies and longer follow-up are needed to confirm long-term outcomes and safety.

Asset Subtitle

Elaine Ognjanovski

Meta Tag

Author List Elaine Ognjanovski, Muhammad Ismail

Category Clinical Vignettes

Concept Gastroesophageal Reflux Disease

Concept Refractory Gastroesophageal Reflux Disease

Concept Transoral Incisionless Fundoplication

Concept Proton Pump Inhibitor

Concept Upper Endoscopy

Distinguished Non-Finalist

Presenter Organization Henry Ford Warren Internal Medicine

Presenting Author Elaine Ognjanovski

Track Adult

Keywords

transoral incisionless fundoplication

TIF

refractory GERD

gastroesophageal reflux disease

EsophyX

endoscopic procedure

hiatal hernia

proton pump inhibitors

esophagitis

acid exposure

Gastroesophageal Reflux Disease

Refractory Gastroesophageal Reflux Disease

Transoral Incisionless Fundoplication

Proton Pump Inhibitor

Upper Endoscopy