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Heartburn running your life? Houston Methodist physicians said there is relief in sight
If heartburn is calling the shots, ruining sleep and disrupting daily routines, Houston Methodist physicians said some people with chronic acid reflux (GERD) may qualify for an incision-free procedure to regain quality of life.
According to Dr. Arturo Bravo, a gastroenterologist with Houston Methodist, GERD is very common and can creep into everyday routines — from sleepless nights to uncomfortable workdays and missed activities. He sees many patients relying on medications called proton pump inhibitors (PPIs) to reduce stomach acid, and for some, they work well. But for others, symptoms like burning, throat irritation, nausea or food coming back up just won’t fully go away. And many patients don’t want to be on daily medication long term.
Bravo said GERD often goes hand-in-hand with a hiatal hernia — when the top of the stomach slides up above the diaphragm and weakens the body’s natural “valve” that keeps stomach acid where it belongs.
In the past, fixing both problems usually meant traditional surgery, which is effective but more invasive, he said. Today, however, some patients may be candidates for a newer option called transoral incisionless fundoplication, or TIF — no external cuts required.
Bravo said TIF is a way to tighten the body’s natural reflux barrier without traditional surgery.
▪ Who it may help: People whose GERD symptoms don’t fully improve with medication, or those hoping to avoid long-term daily meds. A thorough evaluation is always needed to see if it’s the right fit.
▪ How it works: Doctors perform the procedure through the mouth using a flexible tube and specialized tools.
▪ The goal: Help reduce reflux by strengthening the valve between the stomach and esophagus.
“Instead of wrapping the stomach around the esophagus, we create small folds at the base of the esophagus to help the valve close more tightly — aiming for relief without traditional surgery,” Bravo said.
If a patient doesn’t have a hiatal hernia, TIF may be done on its own. If a hernia is present, doctors may recommend a surgery using a robot to repair the hernia combined with the endoscopic TIF procedure.
“We don’t recommend surgery for everyone,” said Dr. Jorge Leiva, a general surgeon at Houston Methodist. “But if medication isn’t fully controlling symptoms, patients shouldn’t feel stuck living with reflux. These are planned, elective procedures — not emergencies — so people have time to learn about their options and decide when or if they want to move forward.”
Bravo and Leiva, both members of the Houston Methodist Lynda K. and David M. Underwood Center for Digestive Health, recently worked together, bringing gastroenterology and surgical techniques to perform the procedure for the first time, helping 21-year-old Emmi Sullivan get her quality of life back.
Sullivan was diagnosed with GERD in 2024, and her symptoms gradually worsened despite taking medication.
“I was nervous because this was my first major procedure,” Sullivan said. “But it was pretty painless, and I no longer have bouts of GERD or nausea.”
She says the experience showed her that even younger adults don’t have to just “live with” chronic reflux.
“The biggest piece of advice I would give others with GERD is don’t give up — and ask for help,” Sullivan said.
Recovery usually requires one to two weeks while resuming light duties, with patients adhering to a liquid diet during the initial two weeks, followed by a soft diet for an additional four weeks to facilitate healing of the esophagus, the doctors said.
“We work together to provide Houston Methodist patients unparalleled care at every step of their journey – from evaluation, to treatment, to recovery,” Bravo said.
The procedure is available at hospitals across the Houston Methodist system. To schedule an evaluation or learn whether you may be a candidate, visit Houston Methodist online or call 713.790.3333.
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Source: Houston Methodist
