LOCAL MAN'S APPETITE RETURNS AFTER SURGERY.
A minimally invasive surgical procedure becoming more widespread is bringing relief to those who suffer from gastroesophageal reflux disease, a type of chronic, painful heartburn.
Canyon Country resident Gary Jenkins, 41, endured the condition for 20 years, avoiding everything from orange juice to spaghetti, carbonated sodas to bananas, because of the physical discomfort he felt after consuming certain acidic, spicy, caffeinated and sweet foods.
Jenkins, an 18-year veteran of the Los Angeles Fire Department, relied on over-the-counter antacids for years to neutralize the symptoms. Eventually, the five or six antacids he consumed in an average day no longer lessened the pain, prompting him to seek a doctor's care and prescription medication to suppress stomach acids.
After several years, that course of treatment grew less effective. Severe heartburn interrupted Jenkins' sleep most nights, even though he elevated one end of his bed to minimize the chance of reflux. Sometimes it was difficult for him to swallow something as bland as water.
Nine months ago, Jenkins underwent an operation that made it possible for him to eat and drink whatever he desires. At the top of the city firefighter's list was a menu favorite from a Los Angeles landmark: a chili burger from Tommy's.
Jenkins said that when he was able to indulge that craving just days after December's operation, he knew he was on the road to recovery.
``The day I had the surgery, from that point on I haven't had a second of heartburn. I can eat anything,'' Jenkins said. ``I would recommend it to everybody.''
Dr. Jeffrey Peters, chief of general surgery at USC University Hospital, performed the operation on Jenkins. The procedure consists of four or five incisions, each measuring a half-inch to an inch long, in the abdominal wall.
``You make two (incisions) underneath each rib and one above the belly button,'' Peters said.
Doctors usually find the patient has a hiatal hernia, one in which part of the stomach protrudes into the opening in the diaphragm through which the esophagus passes.
``We detach some of the blood vessels on the side of the stomach, and then we fold the stomach around the lower esophagus - like you would put a bun around a hot dog,'' Peters explained. ``We suture it in place, and that creates an artificial valve.''
The gastroesophageal reflux condition develops as a result of the weakening of a valve between the stomach and esophagus, Peters said. The medical community hasn't determined whether the syndrome is inherited or the result of an unhealthy lifestyle, he said.
About one-fifth of American adults suffer from the condition in varying degrees, while the problem is less common in Asian and African countries, Peters said.
``It seems to be increasing with time and getting more severe,'' the doctor said. ``It may be the size of the meals that (Americans) eat, and the type of meals that we eat.''
In general, doctors caution gastroesophageal reflux sufferers to avoid too much fat in their diet. It's also not a good idea to skip meals all day long and then eat a big meal right before bed, Peters added.
It's better to get gravity on your side. ``When you lie down, things tend to spill out of your stomach,'' Peters said.
Because sufferers regurgitate acidic fluids, coughing, hoarseness, laryngitis, asthma and pneumonia can result. ``It's important you have a barrier between your stomach and your esophagus, because stomach fluid is very caustic,'' Peters said.
Although the minimally invasive version of the surgery - performed with a device called a harmonic scalpel - has been around since 1991, it is new enough to not be widely known. Yet the operation is established enough to no longer be considered experimental.
Best of all, Jenkins said, most health insurance policies pay for the procedure. ``Nothing came out of my pocket,'' he said. ``Not a lot of (patients) are familiar with it as an option, but the insurance company didn't hesitate to cover it.''
Peters said the operation lasts 90 minutes to two hours, and patients are hospitalized one or two days. Recovery takes an additional one to two weeks, the doctor said.
Patients are advised to avoid meat and bread for a while after the operation. ``Foods like that sort of hang up those valves,'' Peters noted.
Doctors at USC University Hospital, which counts esophageal surgeries among its specialties, perform about 100 of the operations each year, Peters said.
Not only was Jenkins freed of his prescription medications and over-the-counter antacids, his esophagus has recovered. ``It had gotten to where my esophagus was ulcerated so much that it was uncomfortable to drink cold water,'' he recalled. ``It got difficult to swallow.''
Now, Jenkins said, he drinks all the orange juice he wants, eats the German chocolate cake his wife bakes for family birthday parties and generally follows a diet where the only restrictions are common sense.
``I just got used to living with the discomfort,'' Jenkins said. ``But I didn't want to be on medication for the rest of my life.''
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|Publication:||Daily News (Los Angeles, CA)|
|Date:||Sep 28, 1998|
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