TIF Surgery

TIF Surgery

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Heartburn Medicine May Put Your Bones at Risk

The “purple pill” and its brethren are probably no strangers to your television screen — or your medicine cabinet. These heartburn drugs, called proton pump inhibitors (PPIs) are the most popular acid-suppressive medications used worldwide.

For this reason, recent research linking PPIs to an increased risk of hip, wrist, and spine fractures has doctors alarmed. Recent studies have found that people who took PPIs were significantly more likely to break their hipbone or any other bone.

Behind the burn

Heartburn occurs when the muscle between your stomach and esophagus weakens, letting stomach acid back up into your throat. PPIs stop your stomach from producing most of this acid. This eases painful burning symptoms and can also treat ulcers.

But the relief may come with unintended side effects. Changing the acidity of your digestive system affects your body’s ability to absorb bone-boosting calcium. Long-term use of PPIs may also cause vitamin B12 deficiency, damaging your nerves and increasing your risk for falls.

The FDA recently issued a warning about the increased fracture risk from PPIs. People most at risk, it noted, include:

  • Those who take prescription-strength rather than over-the-counter formulas

  • Adults ages 50 and older

  • Those who take PPIs frequently or for long periods of time, for a year or longer

Another form of heartburn medication, called a histamine-2 receptor antagonist, blocks about 70 percent of your stomach acid. This type of medication hasn’t shown the same link to fractures.

Other ways to fight the fire

Be sure to talk with your health care provider about taking over-the-counter PPIs. Your doctor can assess your fracture risk. If it’s high, lower doses or different treatments may relieve your heartburn.            

Lifestyle changes can also help. Try these drug-free solutions:

  • Avoid foods and drinks that make your heartburn worse. Common culprits include coffee, citrus fruits, tomato-based dishes, full-fat dairy, and alcohol.

  • Don’t smoke, or quit if you do.

  • To relieve pain, take acetaminophen. aspirin, ibuprofen, and naproxen can irritate your stomach.

  • Don’t wear tight-fitting clothing.

  • Eat small meals throughout the day, and stop at least 2 hours before going to sleep.

  • When in bed, raise your head 6 inches above your stomach with a wedge support. 

TIF: Incisionless Surgery for GERD using the Esophyx Device



Acid Reflux or GERD is caused by anatomic changes in the body’s natural anti-reflux valve, or gastroesophageal valve. Normally after swallowing the valve between the esophagus and the stomach opens to allow food to pass, and closes to prevent stomach contents from refluxing into the esophagus. Excessive weight, diet, aging and injuries to the abdomen are among the factors contributing to deterioration of the anti-reflux valve. 


TIF (Transoral Incisionless Fundoplication) treats the underlying cause of GERD without incisions. This innovative procedure uses the EsophyX Device to reconstruct the anti-reflux valve and restore the body’s natural protection against reflux. Paul Ulich, MD and Jorge Posadas, MD, are the regional experts in performing this procedure. For information call Winchester Surgical Clinic at (540) 536-0130. Winchester Surgical Clinic is a Valley Health physician practice.

TIF patients reported 80% improvement in the quality of life in recent studies. They also reported reduction or elimination of heartburn symptoms. 79% of patients were completely off daily medications two years after the procedure.

Benefits of Incisionless Acid Reflux Surgery:

  • No external incisions – no scarring
  • No internal cutting or dissection of the natural anatomy – more rapid recovery
  • Fewer adverse events and complication
  • Does not limit future treatment options
  • Can be reversed if required

TIF has been proven to be safe through thousands of procedures performed around the world.  TIF is performed under general anesthesia and will require you not to eat or drink for several hours prior to the procedure.  The procedure will generally take less than one hour.


Most patients go home the day after the procedure and can return to work and most normal activities within a few days. Some discomfort in the stomach, chest, nose and throat should be expected during the first few days to a week after the procedure. Patients will be asked to restrict physical activity for the first week. They are also given dietary guidelines to help maximize the success of the treatment as the tissue heals.