Reader's Digest Australia Feb/Mar 2026

Transoral incisionless fundoplication (TIF) Appropriate for people with small hia- tal hernias, this is a version of fundopli- cation that surgeons perform endo- scopically, placing a camera and tools through the mouth and esophagus to the upper stomach. A barrier is created at the lower esophageal sphincter by folding a portion of the upper stomach over itself and stapling it in place. Tack was involved in a study of the treatment that was published in 2015 in the journal Alimentary Pharmacol- ogy and Therapeutics . He says 59 per- cent of the patients who had TIF did not experience GERD symptoms for six months afterwards (the end point of the study) and were able to stop taking PPI medication. Stretta For this endoscopic procedure, sur- geons insert a camera and catheter via the mouth and esophagus to deliver radiofrequency energy to the esopha- geal wall near the stomach opening. “The idea is that, over time, it strengthens the sphincter muscle,” Tack says. “There is evidence, based onmea- surements of pressure in the sphincter, that it has an anti-reflux effect. How- ever, it is not a huge effect and does not match the efficacy of fundoplication.” LINX Device A band of magnetic titanium beads is placed around the lower esophageal sphincter during this laparoscopic pro- cedure. The magnetic force among the beads helps to tighten the valve, dis- couraging stomach acid from entering the esophagus. When you eat, the force of swallowing moves the beads apart, and food passes easily from esophagus to stomach. Whereas most other GERD proce- dures are irreversible, the LINX device can later be removed if needed. And a hiatal hernia can be repaired during the procedure. Years ago, there were problems with the device, as the beads migrated from where they were implanted. But newer versions of the device fit better and are lighter, so that risk is substantially reduced. RefluxStop During this laparoscopic procedure, which is done under general anaes- thetic, surgeons repair a hiatal hernia, then place a spherical device the size of a ping-pong ball into the upper stom- ach—the area that may contribute to the reflux—to bulk it up. The procedure is reversible. “It restores our anatomy to the way it was before we were suffering from reflux,” Goldsmith says. RefluxStop is the newest GERD treat- ment, and researchers have only two to three years’ worth of safety data. It may appeal to people who worry that tight- ening the lower esophageal sphincter could cause swallowing difficulties. 70    february/march 2026 MARIUSFM77/GETTY IMAGES (LEMONS), ROSEMARY CALVERT/GETTY IMAGES (CHOCOLATE), BARCIN/GETTY IMAGES (PEPPERS), NANTONOV/GETTY IMAGES (PIZZA), CHRIS CLOR/GETTY IMAGES (DRINK), FOODS THAT TRIGGER REFLUX For many people, certain foods or drinks cause reflux, especially acidic and fried foods, caffeine, carbonated beverages and alcohol. Common “trigger foods” are pizza, sausages, cheese, tomatoes, bacon, citrus fruits, chocolate, pepper- mint and anything containing chili pep- pers or black pepper. Avoiding your trig- gers may minimize symptoms. Howmuch you eat, and when, may also impact your symptoms, according to Dr. Radu Tutuian of the Civic Hospital Solothurn in Switzerland. Having smaller meals and not eating late in the evening may ease symptoms. The benefiTs of GERD therapies don’t necessarily last forever. “This is soft tis- sue that moves,” Sweis says—for exam- ple, when you swallow. So, the new structure might change over time. After five or 10 years, some patients need to go back to PPIs if their symp- toms return. “Therapy for your GERD does not necessarily guarantee that you’re going to have 30 years of proton- pump-inhibitor-free life,” says Dr. Ian Gralnek, chief of gastroenterology at Emek Medical Center in Afula, Israel, and president of the European Society of Gastrointestinal Endoscopy. Within a few years, European doctors may be able to prescribe potassium- competitive acid blockers (P-CABs) to treat GERD. The medication, which has been approved in Japan and Korea, is more effective than PPIs at neutralizing stomach acid. “The suppression of the gastric acidity is longer,” Savarino says. “With PPIs, you have to take them one hour before a meal. But with P-CABs, you can take them even if you have just eaten.” Another possible therapy may allevi- ate symptoms in a novel way. “Some researchers are looking at strengthen- ing esophageal lining, which would make it less sensitive,” Tack says. “This is an avenue of further research.” readersdigest.com.au 71