JOSE ERBELLA, M.D., FACS
General, Oncologic & Minimally Invasive Surgeries
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TREATING GASTROESOPHAGEAL REFLUX DISEASE
The severity and frequency of your gastroesophageal reflux disease (GERD) symptoms usually dictate the type of treatment your doctor will suggest for you. In general, your doctor will try conservative methods such as lifestyle modification and medications before recommending surgical interventions.
Modification in eating and activity behaviors is commonly a recommended first step for anyone experiencing heartburn or heartburn-like symptoms.
HABITS THAT CAN REDUCE SEVERITY OF REFLUX SYMPTOMS:
• Identify and avoid dietary triggers
• Reduce or discontinue use of alcohol and tobacco products
• Review medications with your doctor to change those that aggravate GERD symptoms
• Eat early and stay upright for two hours after eating
• Place 6-inch blocks under the legs at the head of the bed or use a wedge-shaped pillow
• Chew gum to stimulate saliva
• If you are overweight, try to lose weight
• Avoid tight clothing
MEDICAL THERAPY FOR ACID REFLUX DISEASE
Over-the-counter remedies are available to control symptoms of occasional heartburn and other acid reflux symptoms. Consult your doctor for advice on which of these medications will be most effective at controlling your symptoms.
TYPES OF MEDICATIONS AVAILABLE TO TREAT ACID REFLUX
Antacids: By reducing the acidity of stomach contents, antacids provide fast relief for mild heartburn. Most antacids are available without a prescription.
H2 Blockers: Available in prescription and non-prescription doses, H2 blockers reduce the production of acid by the stomach.
Proton Pump Inhibitors (PPI): Often prescribed as part of a life-long medication program for GERD, PPIs reduce the production of acid in the stomach and are considered the most effective of the GERD medications.
Coating Agents: Normally used to reduce symptoms where damage of the esophagus already exists, coating agents form a protective layer over the wall of the esophagus to provide an extra layer of protection against stomach acids.
Promotility Medication: Because increased pressure in the stomach is often responsible for acid reflux, medications that stimulate stomach emptying and thereby reduce stomach pressure have been found to be effective in treating GERD symptoms.
In chronic cases of GERD, surgery is becoming an increasingly effective treatment option. Unlike lifestyle change and medication therapy for GERD, surgery treats the cause of the acid reflux instead of simply managing symptoms.
The most frequently used surgical intervention is the laparoscopic Nissen fundoplication. More recently, techniques for performing fundoplication without incisions have been developed. The most notable of these is the TIF EsophyX surgery.
SURGICAL OPTIONS ARE AN EXCELLENT CHOICE FOR PEOPLE WHO:
• Have atypical GERD symptoms such as uncontrolled cough, asthma, or sinusitis
• Cannot tolerate side effects of GERD medications
• Have symptoms that are not relieved by lifestyle change or medications
• Are unable to afford life-long drug treatment
• Do not wish to take GERD medications for the rest of their lives