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Think You Have a Acid Reflux?

Symptoms of reflux and heartburn have nearly doubled in the last decade. GERD can affect your daily activities, your sleep, and your enjoyment of life. And untreated GERD can lead to more serious health conditions. -- Dr. Wright

What is GERD?

Gastroesophageal Reflux Disease (GERD) is a chronic, often progressive disease caused by a weak lower esophageal sphincter (LES) that allows acid and bile to reflux, or flow back, from the stomach into the esophagus.

The LES is a muscle at the junction of the esophagus and stomach that functions as the body's natural barrier to reflux. The LES acts as like a valve, allowing food and liquid to pass through to the stomach. Normally, the LES resists opening to gastric pressures to prevent reflux. In people with GERD, the LES is weak and allows acid and bile to reflux from the stomach into the esophagus, often causing injury to the lining of the esophagus and symptoms such as heartburn, chest pain, regurgitation, sore throat and cough.

What are the symptoms?

Common symptoms of GERD include:

Heartburn: A burning sensation in the chest and/or discomfort in the upper belly or abdomen accompanied by a feeling of fullness.

Regurgitation: The sudden feeling of the contents of the stomach rising from the stomach back into the mouth. A horrible bitter taste and burning in the throat usually accompany it.

Difficulty Swallowing: Although mild difficulty swallowing is often a common symptom of GERD, more severe difficulty swallowing could be a symptom of cancer and should be promptly evaluated by a physician.

Chest Pain: GERD and heart disease share this symptom, so always seek immediate medical attention for chest pain to rule out a possible heart condition.

Other symptoms of GERD you may not expect include tooth decay, gingivitis, bad breath, earaches, chronic cough, worsening asthma, recurrent pneumonias, abdominal bleeding, belching, chronic sore throat, horseness, throat clearing, laryngitis, lump in the throat, or post nasal drip.

How is GERD treated? 

For mild and infrequent symptoms, nonprescription therapy is often enough:

  • Avoid foods that induce reflux (coffee, fat, etc.)
  • Avoid eating close to bedtime and lying down after meals
  • Eliminate smoking
  • Reduce/eliminate alcohol
  • Elevate your head during sleep
  • Lose weight
  • Take over-the-counter antacids as needed (TUMS, Gacascon)

For patients with severe or frequent symptoms of esophagitis:

  • Prescription therapy is almost always necessary in patients who have severe or frequent symptoms. It is important to see your doctor so that he/she can diagnose and treat you and this problem appropriately. Initially, drugs such as Zantac, Pepcid, Tagamet or Axid may be used to treat the symptoms of GERD. In addition to these drugs, lifestyle changes such as losing weight, eliminating smoking and alcohol and avoiding eating too close to bed time are also important to implement.
  • If over-the-counter remedies don't relieve your symptoms, then a proton pump inhibitor (PPI) such as Prilosec, Protonix, Nexium, Aciphex, or Prevacid will most likely be used.
  • Anyone taking over-the-counter antacid medication for more than two months should see his or her doctor.

What should I know about PPIs? 
Proton pump inhibitors are a group of drugs that effectively block acid production in the stomach and relieve the symptoms of GERD. They are safe and generally well tolerated. Unfortunately, they are expensive and usually will require an increase in dosage the longer they are taken. And they are now shown to cause osteoporosis because of impaired calcium absorption. Individuals who, after maximizing medical (non-surgical) treatment for GERD, still experience the following problems should consider surgical treatment for reflux disease:

  • Incomplete relief of symptoms
  • Development of a stricture or esophageal narrowing
  • Barrett's Esophagus
  • Relapse of symptoms after discontinuing medical treatment (after at least eight weeks of medication)
  • Intolerable side effects from GERD medication

Do I have to take the medicines for life? 
That depends on a number of variables, such as the frequency and severity of your reflux (GERD) symptoms, whether you have any complicating conditions (esophagitis, Barrett's), and whether you desire to take daily medications for the remainder of your life. For most patients with frequent or severe symptoms, discontinuing the use of antacid medications will cause the reflux symptoms and GERD to return.

What if my symptoms persist? 
If symptoms persist while you are on medication, you need to see your doctor. He or she may recommend additional testing to confirm the diagnosis and exclude complications of GERD (such as stricture or Barrett's), or a more serious problem.

Do I have options other than taking long-term medications? 
Surgery to improve or prevent GERD has shown excellent results. Patients with GERD that is not well controlled with medicine alone, complicated GERD (severe esophagitis, Barrett's or strictures), the presence of a hiatal hernia and patients who are young and face life-long medication use are considered good candidates for anti-reflux surgery. The surgery to fix GERD and reflux can be performed with varied methods: Hill Repair, Nissen Fundoplication or Toupet repair. Meridian Surgery Center is the been chosen to be a part of a select number of facilities to offer a new FDA approved device called LINX®, which is changing the treatment of GERD.

 

 

 

Dr. Wright and his staff changed the quality of my life and I'll never forget it."
-- Dav B.