Treatment Options for GERD

Treatment Options for GERDGERD, or Gastroesophagael Reflux Disease, is a very common medical condition, affecting up to 40% of adults. While reasons for developing GERD are numerous, it is more prominent with age and obesity. As the baby boomers get older and as our country is experiencing a rise in obesity, GERD will likely become even more prevalent.

Heartburn is the most common symptom, but patients may also experience hoarseness or sore throat, chest pain, sleep disruption, bloating, persistent cough, or intolerance of certain foods. If you have heartburn or other symptoms twice a week or more, you may have GERD.

Premier Surgical Associates general surgeon David J. Harrell MD FACS explains, “When the muscle valve between the esophagus and the stomach weakens, stomach acid goes back up into the esophagus. But the lining of the esophagus is not created to handle acid like the stomach can, which is why you feel the heartburn. Some people have occasional bouts of reflux, but it’s not too drastic. But for others, the reflux is so bad that they can’t even bend over to pick something up.”

Depending on the severity of your acid reflux or GERD symptoms, here are some common treatment options:

Lifestyle Modifications

Diet: For those with mild acid reflux, symptoms can often by managed by not overeating, not drinking too much alcohol, and avoiding acidic and spicy foods, particularly before bed. Some people may find relief by waiting two hours for food to digest before they lay down or go to sleep.

Elevation: Gravity works in favor of digestion when you are upright or when your torso is elevated, and works against you when you lay flat. Some people will elevate their upper body with pillows. If your stomach is full of acid after you eat, and the valve between your stomach and esophagus is already weak, the reflux will worsen. This is why severe reflux symptoms often occur at night, and people may wake suddenly feeling like they’re choking. It’s difficult to go back to sleep after such an alarming incident, and those who suffer from acid reflux may even resort to sleeping in a recliner so they’re not flat on their back.

Medications

Over the counter antacid medicines may be helpful to a degree. While they may help keep the acid under control, stomach bile juice may still come up, which is not pleasant. There are prescribed stomach medications, and some people may take up to two pills twice a day.

However, Dr. Harrell cautions that there may be long term side effects of stomach pills, which shut down the acid production in the stomach but can also decrease calcium absorption.

Osteoporosis patients, for example, can incur more overall health damage by taking the medication. Some patients also show less resistance to colon infections or develop stomach polyps when taking the medication.

Surgery

When a patient has tried lifestyle modifications and medications and is still experiencing symptoms, or has determined that being on medications long term is too great a risk, surgery may be an option.

Severe reflux or GERD may also cause a condition called Barrett’s esophagus, which is when the lining of the esophagus becomes altered to be more like the stomach lining. While Barrett’s is not a cancerous condition in and of itself, it does increase the risk for cancer, and is also a good cause for surgery.

A procedure known as Nissen Laparosopic Fundoplication recreates the valve between the esophagus and the stomach by wrapping the upper portion of the stomach around the lower part of the esophagus and sewing it into place. This tightens the lower esophagus, helping to prevent acid from moving from the stomach up into the esophagus.

If you have heartburn or GERD symptoms despite lifestyle changes, dietary changes, and medication therapy, antireflux surgery might be considered in treating your symptoms. For more information on treatment options and the physicians at Premier Surgical Associates, visit our acid reflux page on at www.premiersurgical.com.

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