Q: What do you think of the TIF (transoral incisionless fundoplication) procedure for relieving persistent gastroesophageal reflux disease? I’ve been on a double dose of proton pump inhibitors and have made lifestyle changes. My symptoms, including hoarseness, sore throat and a sour taste in the back of my throat, are not improving. I’m 56 and never had heartburn until two years ago. — Fred G., St. Louis
A: The TIF procedure is well-accepted, and positive study results support it. The procedure is through the mouth (transoral) and no laparoscope or other skin-puncturing tools are used (incisionless). This reduces the risk of infection and shortens recovery time.
GERD happens when stomach acid enters the esophagus because the door between the stomach and the esophagus — the lower esophageal sphincter or LES — won’t shut all the way. The TIF procedure uses a device called the EsophyX to fasten together reformed and refolded tissue, so that you have a solid anti-reflux door, and GERD goes away. Open and laparoscopic surgical procedures are effective, but they are more invasive and expensive. TIF results seem to be the same, if not better.
The procedure takes an hour or two, requires anesthesia, then there’s a day in the hospital, and you’ll be back at work a day or two after that. However, not all patients with medically resistant GERD are candidates for TIF. So go get checked out by a specialist and see if you qualify for the procedure. Most people who do can say goodbye to antacids and hello to garlic!
Q: I heard that sepsis is the No. 1 cause of hospital deaths. I’m headed in for a hernia operation. What is sepsis, and what are my chances of contracting it?
— Tim J., Lafayette, Ind.
A: Sepsis is the top cause of hospital mortalities. But you can catch it anywhere. There are about 1 million cases of sepsis annually in North America, resulting in 300,000 deaths.
Sepsis (also called systemic inflammatory response syndrome, or SIRS) strikes when the immune system becomes hyperstimulated as it fights an infection, triggering the formation of microscopic blood clots. This clotting can reduce blood and oxygen flow, and can cause vital organs to fail.
People who have a weakened immune system, children, the elderly, people who are obese and those being treated for chronic conditions like type 2 diabetes, kidney disease and asthma are most at risk. When sepsis appears, it is usually because of less-than-perfect sanitary conditions.
Beating sepsis starts with a quick diagnosis and treatment, usually with IV antibiotics and fluids. Make no mistake; it is a medical emergency.
The best way to avoid getting sepsis? Get vaccinated against many of the infectious diseases that can cause sepsis or make it worse, like pneumonia. And make sure when in the hospital that visitors and health-care providers wash hands with sanitizer before they touch you or any medical equipment.
To submit questions to Drs. Oz and Roizen, go to or email youdocsdaily@realage.com
