Patient Instructions
Before and After
Your TIF Procedure
This brochure is intended to give you a general
overview of the TIF
®
Procedure instructions.
ALWAYS follow your doctor’s pre-procedure
and post-procedure instructions.
Pre-Procedure Instructions
Make sure you inform your doctor about all medi-
cations you are currently taking and provide a full
history of your medical conditions.
DO NOT take any diet aids or herbal supple-
ments that contain ginkgo, garlic, or St. John’s
Wort for 10 days prior to surgery.
DO NOT take any aspirin, blood thinners, anti-in-
flammatory (arthritis) medications, vitamin E or
sh oil for 7 days prior to your procedure.
Your doctor will give you additional instructions
regarding medications you are currently taking.
DO NOT smoke or drink alcohol for 48 hours
prior to your procedure.
DO NOT eat or drink anything for at least
12 hours before your procedure (or longer if
instructed by your doctor). The TIF procedure
cannot be performed if there is food in your
stomach.Take the medications your doctor
has approved for you to take with a small
amount of water.
Post-Procedure Instructions
Your doctor will determine whether it is necessary
for you to spend the night in the hospital after
your procedure. For the rst few days, you will
experience some pain and/or discomfort in your
chest and shoulder and you may have a sore
throat, and/or some discomfort swallowing. These
symptoms should resolve within the rst week after
your procedure and appropriate medication will be
provided as needed. If symptoms do not resolve
or if discomfort becomes more severe, notify your
doctor immediately.
Continue to take your GERD medication after your
procedure as recommended by your doctor.
Occasional heartburn is normal in healthy people
and may depend on diet and other factors such
as stress. If GERD symptoms recur, you should
contact your doctor.
Even though the TIF
®
Procedure is incisionless, it is
still surgery. Like any surgical procedure, success
is dependent on how well you adhere to post-
procedure instructions including:
Dietary guidelines
Physical activity, driving
Medications
Return to work
Follow-up
Dietary Guidelines
The strength of your new antireflux valve is largely
determined by how well it heals. What you eat and
drink can dramatically impact the durability of your
antireflux valve. You will be asked to follow a liquid
diet followed by a mashed and soft food diet as
your newly reconstructed valve heals.
If you experience heartburn, write down the food
that gave you heartburn and avoid eating it. Talk
to your doctor at your next visit about your food-
associated symptoms. Remember, its normal for
some people (non-GERD patients) to occasionally
experience heartburn from specic foods, and this
may mean that your valve is functioning correctly.
If your symptoms persist, contact your doctor
immediately.
During the 6-week post-procedure period, it’s
important that you adhere to the following
guidelines:
Eat 4 to 5 small meals consisting of soft
foods throughout the day.
Take small bites and chew your food
thoroughly for 30 seconds to avoid
swallowing a large bolus of food.
Avoid foods with coarse texture: nuts, raw
fruits, and raw vegetables.
Try not to vomit, cough, retch or strain. This
can signicantly affect the healing and
effectiveness of your new antireflux valve.
During the healing process, avoid foods and
drinks that triggered your reflux in the past.
You may reintroduce them slowly after
healing.
To avoid chest pain take small bites, chew for
30 seconds and gradually thicken the texture
of your food.
Remain in an upright position for 1 hour
after eating.
Do not eat for at least 2 hours
before bedtime.
Do not drink carbonated beverages
or alcohol.
Avoid spicy foods.
Avoid foods and drinks that are very hot
or very cold.
Follow your doctor’s instructions to wean
yourself off antireflux medications.
Do not smoke.
Avoid gas-forming, acid producing foods,
or foods that slow gastric emptying such as
tomato-based products, peppermint, black
pepper, caffeinated drinks, alcohol, onions,
green peppers, fatty foods, beans, spicy
foods, citrus fruits, and ber supplements.
Taking over the counter anti-gas medications
may be helpful.
The rst 2 weeks after your procedure are
extremely important. That’s why we ask you to be
particularly cautious with your diet.
You will stay on clear liquids for the rst 1-3 days
after your TIF procedure. This diet contains only
fluids that are clear and very low in sugar. However,
it is not nutritionally balanced and will only be used
a few days.
Avoid beverages with alcohol, caffeine,
carbonation (soft drinks), or acidic drinks (tomato,
grapefruit, and orange juice).
Foods that are allowed:
Water, plain or lightly flavored
(non-carbonated)
Milk, decaffeinated tea, caffeine-free
drinks
Diet decaffeinated drinks
(non-carbonated)
Diluted electrolyte drinks
Strained soups
Diluted, light, or diet apple or white
grape juice
Non-acidic fruit or vegetable juices
(without chunks)
Liquid puddings and creams
Sherbets or Ice-creams (without chunks)
Milkshakes
Baby food
Weeks 1 and 2: Liquid Diet
Be sure to drink a minimum of 4-8 oz of
water between each meal.
Do not take large gulps. Sip clear liquids
and rest between sips. Allow 20 minutes to
drink ½ cup. You may sip on fluids all day if
you wish but at least 6-8 times per day.
Take your prescribed medications. PPIs
should be taken for at least 2 weeks
and wean off according to physician
recommendation. If pills/capsules are
larger than a peanut, discuss with your
pharmacist if they can be halved, crushed
or if there are liquid options available to
minimize hard swallowing.
Take vitamin/mineral supplements every
day being mindful of pill/capsule size as
noted above. This will help prevent vitamin
and mineral de ciencies.
It’s helpful to eat a very low fat diet to
minimize heartburn symptoms.
Restaurant foods are not recommended
during the rst few weeks.
The following protein supplements can be
used starting on day 4:
Protein-enriched commercially available
shakes.
You can also add one scoop of
concentrated protein powder to your
bowl of soup or glass of juice.
During week 2, a liquid diet is still
recommended but you may add very liquid,
potato-based and non-stringy vegetable
mashes.
This diet consists of high-protein full liquids and
blended solids. The portions should remain small
and not exceed ½ cup to help prevent vomiting and
proper healing of your newly reconstructed valve.
Your meals will be only liquid or blended. They may
include milk, vegetable or diluted fruit juice. Sip
liquid meals very slowly. Drink 4 oz (½ cup), over
20-30 minutes.
Eat 4-6 small meals each day. The amount you
will be able to eat at one time is very small and
should not exceed ½ cup. Eat foods high in protein
because they help your body heal from surgery.
Tips on how to blend foods:
Cut foods into small pieces
Place food into blender or food processor
Add liquid such as broth, juice, or milk
Blend or puree until smooth
Strain foods that do not blend in a
completely smooth consistency
Season foods to taste
Water, plain and lightly flavored
(non-carbonated)
Milk, decaffeinated tea,
caffeine-free drinks
Diet decaffeinated drinks
(non-carbonated)
Electrolyte drinks
Apple juice or white grape juice
Non-acidic fruit or vegetable juices
(without chunks)
Strained soups
Liquid puddings and creams
Sherbets and ice-creams
(without chunks)
Milk-shakes
Baby food
Recipes
Protein Fortifi ed Breakfast Drink
½ packet Carnation Instant Breakfast
½ scoop of whey protein powder
4 oz skim milk
Amount per serving (½ cup): 120 calories,
15 g protein
PB Protein Pudding
1 packet sugar-free pudding
¼ cup dry milk
¼ cup peanut butter
2 cups skim milk
Amount per serving (¼ cup): 100 calories,
6 g protein
Eggnog
½ cup skim milk
½ package Carnation Instant Breakfast
¼ cup liquid egg substitute
Amount per serving (½ cup): 110 calories,
13 g protein
Shopping list weeks 1-2
Post Procedure
Day
0-3
Day
4-14
Weeks
3-4
Weeks
5-6
Clear liquids,
low in sugar
Water (non-carbonated)
Milk, decaffeinated tea, caffeine free drinks
Diet and decaffeinated drinks, diluted electrolyte drinks
Broth of any kind, strained soups (not tomato based)
Diluted, light or diet apple or white grape juice
Non-acidic fruit or vegetable juice (without chunks)
Liquid puddings and creams
Sherbets, ice-creams, milk shakes (without chunks)
Full liquids
Drinkable yogurt (no chunks)
Protein-enriched commercially available shakes
Very liquid, potato-based mash
Non-stringy vegetable mash
Baby food
Soft texture,
low fat food
Cottage cheese
Oatmeal
Well-cooked & pureed vegetables (mashed potatoes
Canned fruit (without skins)
Bananas, melons, berries
Soft eggs, tofu
Moist, mashed boneless sh
Well-cooked lean ground food (e.g. turkey)
Medium
texture
food
Small soft noodles
Non-sticky rice
Cereals (softened in milk)
Soft cheeses
Food Guide
No Yes
Milk, fruit and vegetable juices
Tea, coffee
Potatoes and/or vegetables to mash
Oatmeal
Puddings, ice-creams, sherbets
Butter and margarine
Soups (without chunks)
Tofu
Well-cooked ground food: slowly
introduce nely ground sh
or turkey
Pasta (small noodles) and
non-sticky rice
Thicker soups or soups with small
pieces of vegetables
Sauces
Bananas
Soft cheeses
Vegetables (for cooking, steaming)
Shopping list weeks 3-4
Shopping list weeks 5-6
Weeks 3 and 4: Soft Diet
This diet consists of blended foods with one new
solid food added daily. Portions should be small
and not exceeding 1 cup to help prevent vomiting
and proper healing of your newly reconstructed
valve.
Foods that are allowed:
Water, milk, fruit juices and
vegetable juices
Tea and coffee (in small quantities)
Mashed vegetables and/or potatoes
Oatmeal
Puddings, ice-creams, sherbets
Butter and margarine
Soups (without chunks)
Tofu
Slowly introduce well-cooked, nely
ground food such as sh or turkey
Food to avoid:
Raw or undercooked food
Alcoholic and carbonated beverages
Pasta, bread
Cakes, pancakes, waffles, cookies, etc.
Chips, french fries, popcorn, etc.
Pepper and hot sauces
Dry fruits and cereals
High-fat food
Consume vitamin-rich fruit juices each day. Refrain
from acidic fruit juices like orange, lemon or lime.
Plum juice and/or apricot juice will help to
avoid constipation.
Weeks 5 and 6: Solid Diet
Depending on your tolerance level you
may introduce:
Overcooked pasta (small noodles) and
non-sticky rice
Thicker soups or soups with small pieces
of vegetables
Sauces
Bananas
Soft cheeses
Cooked vegetables
Meatless casseroles
Food to avoid:
Fibrous meats
Fibrous vegetables
Eat seated, in a quiet place, without stress.
Chew your food thoroughly. Eat slowly.
Avoid consuming large quantities of food.
Avoid carbonated beverages or alcohol.
If you have a burning sensation after consuming a
particular food, try to avoid it and mention it to your
physician at your next visit.
A burning sensation could mean that your newly
reconstructed valve is operating correctly. However,
if your symptoms persist, contact your physician as
soon as possible.
At the start of the week 7 you can eat normal food.
But try to continue eating small meals.
Physical Activity
Walking is permitted and encouraged after your
procedure. Begin to walk short distances, at a slow
pace, and with someone who can assist you in
case you experience any residual weakness due
to anesthesia. Gradually increase the distance and
duration of your walks until you feel you are back
to normal. You may also climb stairs, although do it
slowly for the rst few weeks to reduce the risk of
increasing abdominal pressure.
In order to give your newly reconstructive valve
time to heal and fuse, do not lift anything over 5
pounds for the rst 2 weeks. During weeks 3-6, you
may lift items up to 10 pounds. Beginning in week
7, lift items you normally would.
Sports and other intense exercise should be
avoided for the rst 6 weeks following your
procedure. Then consult with your doctor to
determine if you are ready to resume your normal
exercise routine.
Driving may be resumed 1-2 days after the
procedure. Do not drive if you are taking
prescription pain medication, are experiencing
fatigue, or are feeling sore.
Sex may be resumed after 7 days.
Medications
Your doctor will determine your need for acid-
reducing medications following your procedure.
Before leaving the hospital, your physician may
prescribe pain medications. It is important that you
take this medication as prescribed. If your pain is
not well managed, contact your physician.
Follow Up
After the procedure, your doctor will see you to
assess the effectiveness of the TIF procedure.
Your doctor may also schedule additional follow-up
appointments.
Return to Work
Most patients will be able to return to work 3-7 days
after the procedure. You and your doctor should
determine a timetable for returning to work based
on a number of factors including residual fatigue
from general anesthesia, any complications during
the procedure, your overall medical condition, and
your general need for recovery time.
If you work in a job that requires
signicant physical activity, you
should not resume all your normal
job functions until after your doctor
has cleared you to do so.
If you are experiencing any of the
following symptoms after your
procedure, call your doctor immediately
or go to your doctor’s hospital’s
emergency room.
Fever greater than 101º F
Increased upper
abdominal pain
Difculty or pain while
swallowing
Sore throat lasting more than
seven days
Chest pain
Shoulder pain lasting more than
3-7 days
Any condition not improving
or worsening
Follow your doctor’s instructions to
wean off antireflux medications.
Monitoring your progress:
It’s helpful to chart your progress from before
your TIF procedure and after. Please answer these
questions today and check in again eight weeks
after your procedure and to see what’s changed.
Rate how you are feeling:
0 = best, 3=neutral, 5 = worst
Before your
TIF procedure
0 1 2 3 4 5
How much does
heartburn bother you
on a daily basis?
How much does
regurgitation bother you
on a daily basis?
Do your reflux symptoms
prevent you from getting
a restful night of sleep?
Does your reflux
condition impact your
daily activities?
How much does coughing
bother you on a daily
basis?
Does your reflux condition
impact your social life?
How dependent are you
on medications to control
reflux symptoms?
Overall satisfaction with
your health condition
Eight weeks after
TIF procedure
0 1 2 3 4 5
How much does
heartburn bother you
on a daily basis?
How much does
regurgitation bother you
on a daily basis?
Do your reflux symptoms
prevent you from getting
a restful night of sleep?
Does your reflux
condition impact your
daily activities?
How much does coughing
bother you on a daily
basis?
Does your reflux condition
impact your social life?
How dependent are you
on medications to control
reflux symptoms?
Overall satisfaction with
your health condition
18109 NE 76th Street, Suite 100
Redmond, WA 98052
Tel: 425-307-9200 Fax: 425-307-9201
www.GERDHelp.com
©2019 EndoGastric Solutions, Inc. All rights reserved. Endogastric Solutions, TIF,
EsophyX and SerosaFuse are registered trademarks of EndoGastric Solutions, Inc.
Important Notice: While clinical studies support the effectiveness of TIF (Transoral
Incisionless Fundoplication) procedure in treating chronic GERD (gastroesophageal
reux disease), individual results may vary. There are no guarantees of successful out-
come. The TIF procedure may not be appropriate for every individual, and it may not be
applicable to your condition. Always ask your doctor about all treatment options, as well
as their risks and benets. Only your doctor can determine whether the TIF procedure is
appropriate for your situation.
NP02500-01A
