Beginning when he was 27, life for the Rev. Earl Reyer was dictated by just how bad his acid reflux and spasms were that day.
“I lived in fear,” Reyer, a Bentonia resident who's now 61, said of pain caused by esophageal spasms so severe they're sometimes mistaken for a heart attack. “When you're a pastor, those short casket funerals are tough. You're standing there representing God, and all the time I'm dealing with stomach issues and reflux and hoping I don't have a spasm in the middle of a service.”
More than three decades and a plethora of medications later, Reyer took a leap of faith. He recently became one of the first patients at the University of Mississippi Medical Center to undergo a procedure using the LINX® reflux management system. It keeps stomach acids from traveling up the esophagus and causing gastroesophageal reflux disease, or GERD.
Generally referred to as reflux, GERD affects 20 percent of the population. It's caused by a weak muscle in the esophagus that allows stomach acid to enter the esophagus and cause chronic inflammation. GERD sufferers typically have burning pain in their chests and throat, trouble swallowing, and the feeling of food sticking rather than being properly swallowed.
The worst cases can put a patient at risk for esophageal cancer and chronic pulmonary disease. In Reyer's case, the ever-present acid also permanently damaged the enamel on his teeth, caused him to curtail travel, and left him sleeping upright in an easy chair. “Reflux took the joy out of my life,” he said. “It takes the icing off the cake.”
After undergoing back surgery last fall, Reyer just weeks later was treated for blood clots in his lungs. “I couldn't get my breathing back,” he said. “I went to the UMMC emergency room. They thought the reflux was affecting my air passages.”
He was referred to Dr. Pierre de Delva, an assistant professor of cardiothoracic surgery and a specialist in reflux and swallowing problems. De Delva told him about the options for treating GERD, Reyer said.
Reflux sometimes can be managed by lifelong medications, de Delva said, but severe cases can require surgery. The standard operation has been Nissen Fundoplication. That surgery can be done laparoscopically and involves wrapping the upper curve of the stomach around the esophagus. The lower portion of the esophagus passes through a tunnel of the stomach, creating a new barrier to reflux.
Only about 1 percent of GERD sufferers end up being referred for that procedure, de Delva said. “About 60 percent are well controlled on medication, but there's a gap of patients who aren't. Providers aren't ready to refer them for surgery because of the perception that the side effects of a Nissen aren't worth it, and because reflux isn't life threatening.”