GERD #3 – Treating GERD
Gastroesophageal reflux disease can cause near constant heart burn and pain, luckily there is hope for treating GERD.
Mark Haltrecht, D.O.
Family Practice Doctor
NSLIJ Plainview Hospital
Gastroesophageal reflux disease or GERD is the result of constant seeping of the stomach’s digestive acids up into the esophagus. GERD must often manifest as chronic heart burn but can also result in vomiting and nausea. If left untreated, GERD can lead to conditions like esophageal stricture which is a painful narrowing of the esophagus and even esophageal cancer.
If you are diagnosed with GERD, your doctor will probably recommend a lifestyle modifications and medications to help you cope with the heart burn that follows from that condition. Life style modifications include avoiding food that can lead to heart burn such as peppermint, chocolate, tomatoes, citrus products, caffeine, and fatty foods.
Your physician may also recommend other changes like loosing weight if you are obese and ceasing use of tobacco products if you smoke. Because GERD is more serious than just basic heart burn, your doctor may prescribe a type of medication called proton pump inhibitors or PPIs. Acid is released in the stomach via a device known as a proton pump.
PPIs block the pump from releasing acid which prevents acid leak and the consequent heart burn. Some common PPIs available via prescription include Nexium and Protonix. While PPIs can reduce acid secretions by more than 95%, a down side is their expensive price tag. A slightly weaker yet more affordable medication choice is histamine 2 or H2 blockers.
These drugs are available both with the prescription and in a weaker form over-the-counter. H2 blockers work by countering the effect of histamine which stimulates acid production. The result is a dropped in the amount of acid that the stomach produces. H2 blockers like Axid and Zantac are often most effective for people troubled by night time heart burn.
Medication and lifestyle changes can control about 95% of GERD but for some people, surgery will become necessary. The goal of GERD surgery is to tighten the lower esophageal sphincter that went loose allows acid to leak. The most common GERD surgery is fundoplication or a stomach wrap. This procedure involves grabbing a piece of the stomach and looping it around the lower end of the esophagus to create a sphincter. The warp must be tight enough to prevent a reflux but loosen up to allow food and belches to pass.
Sometimes a doctor will use radiofrequency catheter ablation to treat GERD. Also known as the Stretta procedure it involves applying small doses of radiofrequency energy into the esophageal sphincter. This causes the lining of the esophagus to expand in turn resulting in a tightening of the valve that releases acid. The LES can also be tightened with sutures using the Bard endoscopic suturing system. During this surgery, stitches are placed at either side of the LES and are then tide together.
While gastroesophageal reflux diseases can be painful, these treatment options can help you return to a normal heart burn free life but please see your doctor before trying any GERD therapy.
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