Greasy food promotes heartburn
One in ten Germans suffers from heartburn. While suffering can often be alleviated by medication, in persistent cases there is only one operation. With a new, minimally invasive procedure, this procedure can be carried out more gently. After a good meal unpleasant hours begin for some people: When the stomach is working at full speed and the food is kneaded with plenty of stomach acid, they must be worried. Your natural closure valve between the stomach and the esophagus does not work properly anymore. The transition between both organs is thereby extended. Every now and then, a surge of intense stomach acid shoots up unhindered. Sometimes the biting liquid even floods into the mouth. It causes heartburn.

In Germany, every tenth regularly suffers. This is especially unpleasant and cumbersome. On the other hand, suffering is only dangerous in exceptional cases. Sometimes the burned esophageal mucosa becomes inflamed or bleeding occurs. "A progression to esophageal cancer occurs very rarely on the current state of science, " Karel Caca, medical director at the Klinikum Ludwigsburg, told ddp.

However, many heartburn sufferers feel so unwell that they seek treatment. "The standard therapy is with drugs, so-called proton pump inhibitors. These substances suppress the production of gastric acid, "explains Caca. In general, the tablets are well tolerated, but they must be taken for life. "There are patients who do not want this, and some who are not free from any complaints, despite medicines, and very few who have to resort to another treatment because of rare side effects, " says Caca.

An alternative is an operation. In this procedure, the transition between stomach and esophagus is artificially narrowed. Here, a part of the stomach is sewn around the mouth of the esophagus. "The tissue is scarring at the operated site. This is a surgical procedure that is difficult to undo, "says Caca. About 85 percent of operated people are satisfied with the result afterwards. However, the other 15 percent see no improvement or even new, some persistent complaints. display

Gentle and gentle for the patient is the operation with a new special surgical endoscope that allows the heartburn to be treated in a completely new way. The device is called a plicator. It resembles a simple, thumb-thick tube, which at the end is formed into a bow. The doctor pushes the device over the mouth of the anesthetized patient into the esophagus. The instrument hides in its inside in truth both a sewing machine and two gryphons and a camera. At that eroded passage between stomach and esophagus, these tools emerge from the tube. First, the tiny arm grabs a piece of stomach wall and folds it to a fold. Then the fold is sewn off with a plastic thread. One last examining look at the pictures of the camera and the new closure between stomach and esophagus is done. The stitched fabric fold will serve as a dam against the acid.

In recent months, the new minimally invasive procedure has been tested on 159 patients worldwide. In addition to ten American centers, two clinics in Europe were involved in the study - including Caca's team in Ludwigsburg and previously in Leipzig, as well as a second research group in Brussels. "The results are very encouraging: in all patients the sutures were preserved after three months. 60 percent were completely without medication, with all the symptoms improved. It increased less and also less stomach acid in the esophagus, "says Caca. In mid-November, the results were presented at a gastroenterologist congress in the United States. "However, it is too early to say that it would be a perfect process. There is a lack of long-term data, "Caca admits. He expects this in about two years, when the 159 subjects are finally examined.

Meanwhile, the process is already being developed. Patients with heartburn are again being selected for a study at the clinic in Ludwigsburg as well as at the international partner clinics. This time the abdominal fold should not only be fixed with a simple suture, but with a double suture. The physicians hope to make the artificial bulge even more precise.

However, Caca already knows that the new minimally invasive method will not displace medication or conventional surgery altogether. Colleagues like Karl-Hermann Fuchs from the Department of Visceral and Thoracic Surgery of the Frankfurt Diakonie-Kliniken are of the same opinion: "I think the new technology will find its place in the treatment of minor reflux diseases. In severe cases, the Plicator is overwhelmed. "

ddp / science.de - Susanne Donner

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