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Dr. Andrew Rynne

Family Physician

Exp 50 years

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If one suffers with motility issues can the TIF procedure

Answered by
Dr. Ramesh Kumar


Practicing since :1986

Answered : 1993 Questions

Posted on Thu, 29 Mar 2018 in Digestion and Bowels
Question: If one suffers with motility issues can the TIF procedure still be performed? Is the TIF like the nissen Fundoplication in respect to being able to do a partial wrap 180-240 ?
Do you know of the best surgeons for the TIF procedure in Long Island New York area ? Also, what would you personally do? TIF or Nissen? Thanks
Answered by Dr. Ramesh Kumar 12 hours later
Brief Answer:
You are a candidate for fundoplication.

Detailed Answer:
Hello and thanks for choosing HealthcareMagic for your query.

Motility issues with improper sphincter contraction are a contraindication to TIF.
No fundoplication is much better as concerned to TIF specially in 180-240.
I would have performed Fundoplication on you.It would give much better results in you case.
Lastly limited or slow mobility is a contraindication for this procedure.
Go for Fundoplication.

Hope i was helpful.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Ramesh Kumar 10 hours later
One more question...

If your sphincter is lax or not closing properly, does that automatically mean you need surgery? Do all people with Gerd have sphincter problems and some can control this with just medication?

Answered by Dr. Ramesh Kumar 13 hours later
Brief Answer:
Surgery is done when medicines are not successful.

Detailed Answer:
Hello again my dear patient,
Surgery means intervention and usually as a rule of thumb interventions are done only when patient is not relieved despite maximal medical therapy.

So ask your gastroenterologist to start you on PPI-antacids like Esomeprazole.It can be used in the dosage as high as 80 mg twice daily.Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms. Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back.
An antacid containing local anesthetic (Mucaine gel ) should be taken 2tsf thrice daily.

Acotiamide is a wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.

All these drugs can be considered by your gastroenterologist to provide you with symptomatic relief in your problem.All these medicine can be used at a time also by your primary.If you have tried all of them orIf not relieved despite of this then go for surgery.
Yes spincteric problem is always there as gerd means reflux of acid back into esophagus.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

The User accepted the expert's answer

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