Skip Section Navigation


Published on June 30, 2015

New incision-free treatment for GERD being done as part of trial at St. Vincent's Riverside

By Charlie Patton, Florida Times-Union

For Jeanne Barzyk, a 63-year-old retired postal worker, a new procedure performed by Ali Lankarani, a board-certified gastroenterologist with the Borland-Groover Clinic, St. Vincent’s Riverside, has been life-changing event.

She became the third person Lankarani treated with an incisionless procedure to deal with gastroesophageal reflux disease, usually referred to as GERD.

GERD occurs when the lower part of the esophagus does not close properly and stomach contents and/or acid rise up into the esophagus, causing irritation. While most people are able to manage GERD with medications, more severe cases involve surgical intervention. Until recently that involved laparoscopic surgery through small incisions. Now a device called MUSE allows for an incisionless procedure.

Oddly, Barzyk didn’t know for a long time that she had GERD, since she was suffering from what is called silent GERD. Her symptoms were congestion in her nose and chest and a hacking cough, which were making her life miserable. Sometimes, she said, she would have prolonged coughing sessions so violent her chest would ache.

She attributed her issues to a return of the asthma she suffered from as a child. So she sought out an ear, nose and throat specialist. The specialist gave her a nose spray to help open her sinuses and told her to see a gastroenterologist.

Though she had never suffered from heartburrn, an endoscopy, a procedure in which a flexible tube with a light and camera attached is used to examine a person’s digestive tract, found Barzyk’s “acid level was extremely high,” she said.

As a result, acid reflux was affecting her throat and getting into her lungs, aggravating her asthma. Doctors tried treating her condition with medicine, gradually upping the dose until she was taking the highest dose of reflux medicine that was considered safe.

“My condition didn’t change at all,” she said. “I was extremely sick.”

She was also worried about the effect the high levels might have on esophagus.

“You can get cancer from it,” she said. “It eats up your esophagus.”

That’s why she ended up seeing Lankarani. Although the new procedure called MUSE has been approved for use by the Food and Drug Administration, it is still in the trial phase.

“We have done several cases with the MUSE as part of a study here in the U.S.,” Lankarani said. “We are in very elite company as the other trial sites are Johns Hopkins and Winthrop University.”

Since health insurance companies don’t cover the procedure — Lankarani said he hopes coverage will become standard next year — he is doing only a handful of procedures at the moment. But he felt it was right for Barzyk.

The MUSE gains access to the malfunctioning section of the esophagus through the patient’s mouth. The system includes a camera, ultrasound, illumination and stapler in one small device.

“The endoscopic device allows for patients to be treated without incisions and the result is no blood loss, less pain and much quicker recovery, Lankarani said.

“The way this works mainly offering to patients whose symptoms aren’t controlled by medication. For those patients this is perfect.”

Lankarani did Barzyk’s procedure in April.

“Now I’m completely off the medicine,” she said. “My asthma is doing great. … I feel so much better.”

View the story: