50's female patient with long-standing reflux.  On meds that don't work anymore.  You can actually hear the 'bubbling cauldren' when she talks!  Have worked on St, LV. You can actually hear the 'bubbling cauldren' when she talks! Working on the ileoceal valve turns the reflex off like a switch! But it won't hold the correction.

She has a medium amount of abdominal adipose tissue that is very firm
and cannot lie down without severe esophageal burning/reflux.  It
stops when IC valve is adjusted.  Have showed her how to adjust IC
valve, but that doesn't seem to be working for her.

She eats every meal out and will not consider changing this habit.  Can
you think of something else I can be doing for the lady?