Gastroesophageal Reflux Diagnosis and Treatment Center

Gastroesophageal Reflux Center No Reflux Missed, Diagnosis and Treatment Unstoppable, Multidisciplinary Consultation to End Gastroesophageal Reflux Differences between Reflux Laryngitis and Gastroesophageal Reflux

Introduction to Diagnosis and Treatment Items

In the country, up to a quarter of the population is troubled by gastroesophageal reflux. In addition to typical heartburn symptoms, atypical symptoms such as cough and globus sensation often prevent work and sleep, and even lead to mental illness and tragic suicides. Some patients with refractory gastroesophageal reflux require surgical treatment to improve. We are committed to personalized precise diagnosis and integrated treatment of gastroesophageal reflux with the latest instruments and medical concepts, producing 40 educational videos to promote patient education, introducing the latest esophageal function examination equipment to diagnose patients, pioneering endoscopic minimally invasive surgery to treat refractory esophageal reflux patients, and offering the "Reflux Easy Pass" multidisciplinary consultation method to integrate treatment across departments, ending gastroesophageal reflux together, improving patients' quality of life, and relieving the burden of long-term medication.

Introduction to Features

The Gastroesophageal Reflux Diagnosis and Treatment Center is the first institution in the country to introduce advanced foreign instruments and equipment related to gastroesophageal reflux, including the minimally invasive surgery equipment for gastroesophageal reflux in October 2017, the 24-hour esophageal pH and impedance equipment in 2018, the 96-hour wireless esophageal pH capsule (Bravo capsule), the Chicago guideline esophageal pressure instrument (Manoscan) in 2019, the 3D endoscopy system, and capsule endoscopy equipment. These new medical instruments and equipment require hospital integration and provide clinical application methods for the domestic medical technology industry to improve the current domestic difficulties in diagnosing and treating gastroesophageal reflux, especially the leading introduction and teaching of endoscopic minimally invasive surgery such as radiofrequency fundoplication (STRETTA) or anti-reflux mucosectomy (ARMS). In addition to domestic and foreign medical experts coming to the center for learning and exchange, it also frees patients from the predicament of ineffective long-term medication.

Introduction to Treatments

1. 3D Endoscopy Examination

The 3D gastrointestinal endoscopy examination system is a globally leading medical technology independently developed by Taiwan. Our center is the first in the world to introduce this system for clinical examination. The stereoscopic presentation helps doctors detect small concave and convex lesions, increases the accuracy of endoscopy and colonoscopy surgeries, and reduces surgery time.

2. 3D Consultation Room

The 3D gastrointestinal endoscopy examination system can also archive the examination process through video equipment. Patients can wear 3D glasses to gain a deeper understanding of the examination results and process, which is also the world's first doctor-patient communication system.

3. 3D Capsule Endoscopy Examination

The capsule endoscopy is a domestically developed endoscopy examination system. Our center is the first to introduce this technology and combine it with another Taiwanese innovation, 3D imaging, significantly reducing the discomfort of endoscopy examinations for patients and lowering the risk of cross-infection due to single-use. Our center is also the first in the world to implement 3D capsule endoscopy.

4. "Reflux Easy Pass" Multidisciplinary Consultation

Patients with refractory gastroesophageal reflux symptoms often require multidisciplinary consultations, including ENT, psychiatry, rehabilitation, nutrition, thoracic surgery, endocrinology, and psychosomatic departments. In the past, patients had to register and find doctors themselves, lacking team communication, which was inconvenient for patients. Our center designed the "Reflux Easy Pass" method, which not only helps patients register for relevant departments but also writes the consultation issues on the Easy Pass consultation form, speeding up the focus for other department doctors.

5. 96-hour Wireless Esophageal pH Capsule Examination (Bravo capsule)

Our center is the first in the country to introduce the 96-hour wireless esophageal pH capsule examination and establish the standard process for this examination for other hospital doctors to refer to. This examination helps identify pseudo-reflux patients who have been taking stomach medicine for a long time. The examination is more comfortable than the traditional catheter method, and the examination time can last up to 4 days, effectively diagnosing patients with intermittent reflux. Currently, in addition to guiding hospital doctors in execution, we are also working hard on patient education to promote the pseudo-reflux medication cessation campaign.

6. Endoscopic Radiofrequency Ablation Surgery (Radiofrequency ablation)

Endoscopic radiofrequency ablation surgery is the standard surgical method for treating Barrett's esophagus, a precancerous lesion caused by long-term gastroesophageal reflux. Our center is the first in the central region to introduce the 360EXPRESS radiofrequency catheter system, quickly and effectively treating Barrett's esophagus and preventing esophageal cancer. This surgery was fully covered by health insurance on June 1, 2020, reducing the burden on patients, truly a blessing for patients.

7. Low Risk Radiofrequency Fundoplication (Low risky Stretta)

Radiofrequency fundoplication (Stretta) is the latest endoscopic minimally invasive surgery method in the country, mainly treating refractory gastroesophageal reflux patients, helping improve quality of life and stop medication use. Our center is the first hospital to introduce this equipment, and Director Wu is the first doctor in the country to introduce this surgery, with over 200 successful cases. Traditionally, the Stretta procedure was performed under intravenous anesthesia in the endoscopy room, but it may have higher anesthesia instability and complication risks. Our center pioneered the "Low Risk Radiofrequency Fundoplication," performed under intubation general anesthesia in the operating room under safe standards, controlling breathing and protecting the airway, reducing potential surgical risks. This method is set as the standard surgical execution method and shared with domestic and foreign doctors for learning.

8. Anti-reflux Mucosectomy (ARMS)

Anti-reflux mucosectomy is the second new endoscopic minimally invasive surgery method in the country, mainly forming ulcers by removing mucosal tissue at the cardia with an endoscope. As the ulcers heal in two months, the loose cardia tightens, treating refractory gastroesophageal reflux patients, helping improve quality of life and stop medication use.

• Main Indications

1. Patients with gastroesophageal reflux symptoms but uncertain diagnosis
2. Patients with atypical symptoms such as globus sensation and chronic cough but uncertain diagnosis
3. Patients on long-term stomach medication for gastroesophageal reflux who cannot stop medication
4. Barrett's esophagus
5. Early esophageal cancer

• Case Sharing

1. A woman in Changhua County had a sore throat and went to the ENT department for treatment. After taking medicine for half a year without improvement, she later found out at Yuanrong Hospital that she "saw the wrong department and found the wrong doctor." The woman actually had "gastroesophageal reflux," as the relaxation of the cardia (between the stomach and esophagus) caused food in the gastrointestinal tract to block after digestion, unable to move down to the stomach, and stomach acid refluxed to the throat, feeling like an "egg" stuck in the throat. The woman was completely cured after "radiofrequency fundoplication" surgery. She said that in April last year, she had a sore throat and thought it was a cold, so she went to the ENT department for treatment. After taking medicine for 3-4 months, the condition was sometimes good and sometimes bad. Later, a nasal endoscopy showed no problems, and the doctor judged it was throat pain caused by gastroesophageal reflux. After being referred to the gastroenterology department, she was diagnosed with gastroesophageal reflux, but after taking medicine for 4 months, the symptoms remained. Further diagnosis confirmed it was "cardia relaxation" causing gastroesophageal reflux, and she was completely cured by undergoing "radiofrequency fundoplication" surgery at her own expense.

2. Mr. Guan is a patient with refractory gastroesophageal reflux. He often felt acid reflux since he was 20 years old. Four years ago, an endoscopy found a hiatal hernia with the stomach sliding upwards, so he underwent a 360-degree laparoscopic fundoplication, but post-surgery he experienced swallowing difficulties. For 8 months, he could only eat liquids, underwent 4 surgeries for adjustments, and had to spit out chewed food without swallowing. His weight dropped from over 100 kg to 50 kg, and he had to sleep sitting up to avoid reflux. Suffering greatly, Mr. Guan transferred to Yuanrong Hospital's Yuansheng Campus in June this year for radiofrequency fundoplication surgery. After the surgery, he not only gained weight but also stabilized his work, and rarely took acid medication. Wu Wenjie said that Guan is a successful case of minimally invasive treatment and the first case in the country where a patient with failed surgical treatment was cured of gastroesophageal reflux using minimally invasive techniques.

3. A male patient around 50 years old had long-term food reflux, foreign body sensation in the throat, bad breath, and a bitter taste in the mouth. Due to a busy work schedule, he self-diagnosed as having gastroesophageal reflux and did not see a doctor, only buying over-the-counter medicine. Recently, his symptoms worsened, often experiencing chest tightness and insomnia at night. The original medicine did not improve the condition, and he worried it might be esophageal cancer, finally deciding to seek medical attention. Endoscopy revealed severe reflux esophagitis and a 3 cm "Barrett's esophagus" (according to statistics, about 90% of people have never heard of this term). Barrett's esophagus is actually a "precancerous lesion of esophageal cancer." Upon hearing it was related to cancer, he realized the seriousness of the situation. Later, in addition to medication, he was advised to change his lifestyle habits. After detailed communication, he underwent two sessions of esophageal radiofrequency ablation and, within a year, through medication and dietary control, overcame the troubles of gastroesophageal reflux and Barrett's esophagus.