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BODY : FITNESS & EXERCISE SURGERY DOUSES THE FIRE OF CHRONIC HEARTBURN.



Byline: Noel Holton

Mark Robinson, a 39-year-old construction worker, began suffering from heartburn heartburn, burning sensation beneath the breastbone, also called pyrosis. Heartburn does not indicate heart malfunction but results from nervous tension or overindulgence in food or drink.  at an age when most people consider pizza, soda and ice cream a balanced diet balanced diet
n.
A diet that furnishes in proper proportions all of the nutrients necessary for adequate nutrition.


balanced diet 
.

``I have had chronic heartburn since the age of 18,'' Robinson said. ``They started giving me upper and lower GI's when I was 19 because the pain that I felt was so intense.''

So began a 20-year relationship with heartburn, one marked by frustration each time he tried a new medication and it failed to help.

His doctor eventually determined that he had severe ulcerations Ulcerations
Breaks in skin or mucous membranes that are often accompanied by loss of tissue on the surface.

Mentioned in: Hypersplenism
 on his esophagus, caused by the constant irritation of stomach acid.

``My heartburn was so bad that I had to sleep sitting up,'' Robinson said. ``If I didn't position myself at a 45-degree angle before I went to sleep, whatever I had eaten that day would come right back up into my chest and wake me up.''

Finally, in March, Robinson got the relief he was looking for Looking for

In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with.
, not with a pill, but with a new type of surgery called laparoscopic Laparoscopic
A minimally-invasive surgical or diagnostic procedure that uses a flexible endoscope (laparoscope) to view and operate on structures in the abdomen.

Mentioned in: Obstetrical Emergencies
 fundiplication.

The idea behind the surgery is to get the sphincter of Oddi The Sphincter of Oddi, also called the hepatopancreatic sphincter or Glisson's sphincter, controls secretions from the liver, pancreas, and gallbladder into the duodenum of the small intestine.

It is a sphincter muscle located at the surface of the duodenum.
 (the muscle located between the stomach and the esophagus) to do its job: namely, to contract so that swallowed food stays where it belongs - in the stomach.

Working through several half-inch abdominal incisions and using a tiny video camera to lead the way, a surgeon took the top part of Robinson's stomach, called the fundus fundus /fun·dus/ (fun´dus) pl. fun´di   [L.] the bottom or base of anything; the bottom or base of an organ, or the part of a hollow organ farthest from its mouth. , and wrapped it around the lower end of the esophagus. The wrap was intended to create enough pressure in the stomach so that the sphincter muscle would open only when it was supposed to and not allow stomach acid to push its way up into the esophagus.

Such an operation used to require a big incision and would keep patients in the hospital for weeks.

``I'll admit I was more than a little nervous about undergoing surgery,'' Robinson said. ``But I am so glad I did it. Now, I can eat anything I want; grapefruit juice, pizza, whatever. And I was out of the hospital in one day.''

Laparoscopic surgery laparoscopic surgery: see endoscope.  for chronic heartburn was introduced about four years ago.

George Costantino of St. Mary's Hospital in Langhorne, Pa., has done nearly 50 of the heartburn surgeries, including Robinson's. He believes the new laparoscopic technique, covered under most major health plans, is a good option for some patients with chronic heartburn.

``I see people at the end of their rope,'' Costantino said. ``They have already tried medication for years and they still get symptoms. These are the best candidates for laparoscopic surgery, and they all report high satisfaction with the results.''

But Michael Wolfe, a gastroenterologist and author of a book about heartburn, ``The Fire Inside,'' said there isn't enough information on the success of heartburn surgery to warrant enthusiasm about the new laparoscopic procedure.

``If you have surgery, you are obviously doing it for the long-term effects,'' Wolfe said. ``There should, therefore, be long-term studies done on the outcomes of these operations, and there just aren't any.''

Some small studies with short-term follow-up, published in Journal of the American College of Surgeons This article or section needs sources or references that appear in reliable, third-party publications. Alone, primary sources and sources affiliated with the subject of this article are not sufficient for an accurate encyclopedia article. , have found that the procedure is safe and effective.

A recent study by New York College-Cornell Medical Center estimated that approximately 60 million Americans suffer from heartburn, at least occasionally. Symptoms can range from mild abdominal pain and a burning sensation in the chest to difficulty swallowing and sour, acidic regurgitation regurgitation /re·gur·gi·ta·tion/ (re-ger?ji-ta´shun)
1. flow in the opposite direction from normal.

2. vomiting.
.

For most people, heartburn is brought on by consuming fried, greasy or spicy foods, chocolate, citrus fruits or coffee.
COPYRIGHT 1996 Daily News
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1996, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:L.A. LIFE
Publication:Daily News (Los Angeles, CA)
Date:Aug 5, 1996
Words:594
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