Treatment for Gastro Reflux Disease

Most minor symptoms can be treated with lifestyle changes and over the counter medications.  Most patients will need to avoid foods that bring on the symptoms, stop smoking if they are a smoker, eat smaller meals more frequently throughout the day, and sleep with the head of the bed raised 6 to 8 inches.

There are several different medications that are available to treat GERD.  These include antacids (e.g. Alka-Seltzer, Mylanta, Tums, and Rolaids), H2 blockers (e.g. Tagamet, Pepcid, and Zantac), proton pump inhibitors (e.g. Prilosec, Prevacid, Nexium, and Protonix).  If you develop worsening or uncontrolled symptoms despite medications, you should talk to your doctor for more recommendations.

Surgery is an option when conservative therapy fails.  The standard surgical treatment is called a fundoplication.  In this operation, the upper part of the stomach is wrapped around the lower esophagus at the level of the LES.  This procedure strengthens the LES and prevents acid reflux.  This operation is most often performed using laparoscopy.  Laparoscopy is a minimally invasive technique that involves making small incisions instead of a single large incision.  Long instruments are used along with a video camera, so that all the surgery takes place from outside the abdomen.

Procedures using endoscopy are also available.  Endoscopy refers to using a long flexible camera that is inserted down through the mouth so that the inside of the esophagus and the stomach can be seen without having to make an incision in the abdomen.  Particularly, a new procedure known as EsophyX allows an incisionless fundoplication performed from the inside of the stomach.  Transoral Incisionless Fundoplication (TIF) with EsophyX corrects GERD by reconstructing an anti-reflux valve from inside the stomach to tighten the LES, creating a new barrier to reflux.