Treatment Options
Lifestyle Modifications
The first step in treating mild acid reflux often includes lifestyle and diet modifications:
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Avoid food, beverages and medications that can aggravate acid reflux symptoms: spicy foods, fatty or fried foods, chocolate, peppermint, alcohol, caffeine, soda, mustard, citrus or fruit juices, vinegar and tomato products, including ketchup.
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Decrease portion sizes at mealtime
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Eat meals at least two to three hours before bedtime and go to sleep with an empty stomach
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Elevate the head of your bed four to six inches or use a wedge
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Lose weight
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Exercise with an empty stomach
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Avoid tight clothing
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Stop smoking
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Avoid stress
Medications
In addition to lifestyle changes, there are a number of over-the-counter and prescription medications available to relieve moderate or severe acid reflux symptoms. Some of these medications neutralize stomach acid while others help stop acid production. For most, medications are effective, but they may require lifelong use for continued control of symptoms.
There are several classes of medications that may help in controlling the initial signs and symptoms of heartburn/GERD:
Over-the-counter (OTC) medications are designed for short-term use (two weeks). If your symptoms continue you should contact your physician or one of our GERD experts.
Antacids neutralize acid in the stomach. Examples of antacids include Rolaids®, Tums® and Maalox®.
H2 Blockers reduce acid production. Examples of H2 blockers include Zantac®, Pepcid® and Axid.
PPI's proton pump inhibors effectively stop acid production. Examples of PPI's include Omeprazol, Prevacid® and Nexium®.
Prescription strength medications of the H2 Blockers and PPI's are commonly prescribed. These often are very effective in treating the side-effects of heartburn, though they do not treat the underlying cause. Furthermore, new data about PPI's (Nexium®, Aciphex®, Prevacid®, Prilosec®, Protonix, Dexilant) raises concerns about long-term use. You should ask your primary physician or one of our experts if you are taking these medications longer than three months.
Surgery
Medications work in about 90 percent of people with acid reflux. However, they don't work for everyone and don't repair the cause of acid reflux. For moderate or severe acid reflux, surgery may be a treatment option if:
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You continue to suffer from persistent heartburn, or other reflux symptoms, while taking medication
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You are concerned about or develop adverse side effects such as osteoporosis as a result of taking medication
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Symptoms return when therapy is stopped
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Your esophagus is damaged (bleeding/stricture)
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You prefer not to take lifelong medication or feel you cannot afford to do so
Advanced Surgeons, P.C. now offers the LINX® Reflux Management System
The LINX® System is the only FDA-approved treatment for GERD to stop reflux at its source. It is implanted laparoscopically in a minimally invasive procedure that typically takes less than one hour.
The LINX® Reflux Management System
Medications for Gastroesophageal Reflux Disease (GERD) are designed to control or suppress acid production in the stomach. But they do not address the cause of GERD, a weak sphincter muscle, and can't prevent reflux. Approximately 40 percent of GERD sufferers continue to have symptoms while taking medications.
The LINX® Reflux Management System is the only available FDA-approved device to treat GERD at its source.
How Linx Works
How does LINX® work?
The LINX® System is a small, flexible band of magnets enclosed in titanium beads. The system is implanted around the weak lower esophageal sphincter (LES), which is located just above the stomach. The magnetic attraction between the beads keeps the weak esophageal sphincter closed to help prevent reflux. Swallowing forces separate the beads temporarily to allow food and liquid to pass into the stomach.
How long is the procedure?
LINX® is implanted laparoscopically in a minimally invasive procedure that typically takes less than one hour. Patients generally go home within one day.
What kind of results can I expect?
LINX® study results appeared in New England Journal of Medicine. The three-year results of the five-year clinical study assessed 100 patients with chronic GERD before and after treatment with the LINX System.
Results showed that after treatment:
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91 percent of patients achieved freedom from GERD medication
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92 percent of patients achieved significant symptom improvement
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100 percent of patients eliminated severe regurgitation
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99 percent of patients eliminated daily sleep disruption due to heartburn
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94 percent of patients were satisfied with their overall condition
Laparoscopic Nissen Fundoplication
Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus. This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus.
It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.
Following surgery, patients stay in the hospital for one night. They start drinking one day after surgery and are discharged home. They will follow dietary restrictions for about two weeks and can start advancing their diet after the clinic visit two weeks after surgery.
This procedure is routinely performed at Grandview Medical Center for the treatment of patients with gastroesophageal reflux disease.
References
1. Campos GM, Peters JH, DeMeester TR, Oberg S, Crookes PF, Tan S, DeMeester
SR, Hagen JA, Bremner CG. Multivariate analysis of factors predicting outcome after
laparoscopic Nissen fundoplication. J Gastrointest Surg 1999;3:292-300.
2. Epidemiology of gastroesophageal reflux disease: a systematic review Gut
2005;54:710-717
3. Farzaneh Banki, Tom R DeMeester. Treatment of complications of gastroesophageal
reflux disease and failed gastroesophageal surgery. Oesophagogastric Surgery, A
Companion to Specialist Surgical Practice: Michael Griffin, Fourth Edition, 2009, page
281-292
What is significant about a hiatal hernia?
Acid reflux and GERD are not always caused by a hiatal hernia, but they have shown a correlation. Since hiatal hernias can be difficult to detect, it is important to seek expert medical guidance if you experience any symptoms of acid reflux. Both hernias and acid reflux are very treatable conditions, but can cause serious problems if ignored. Many cases can be treated without surgery, but the risk of complications and worsening symptoms may make surgery necessary.
Thankfully, the expert team of doctors at Advanced Surgeons, PC offers the latest diagnostic testing and most minimally-invasive techniques for repairing hernias and eliminating symptoms of acid reflux, no matter the cause or condition.
Heartburn Assessment Test
To find out what treatment options may be available for your heartburn and acid reflux symptoms,
fill out the short assessment below for our physicians to review.
Acid Reflux FAQ
Q: When is surgery necessary to treat my reflux?
A: Surgery is a good option for patients whose reflux does not respond to medication or lifestyle changes. Furthermore, any patients with esophagitis, ulcers, or esophageal scarring should consider surgery to protect the health of
the esophagus.
Q: How long will I be at the surgery center after reflux surgery?
A: Most patients would have a one night stay at Grandview Medical Center after undergoing laparoscopic surgery.
Q: What lifestyle changes are required after reflux surgery?
A: After undergoing reflux surgery, you will need to make certain dietary and lifestyle changes. You may notice you have to eat slower and smaller meals but should have no restrictions on food types, even those that before surgery may have caused reflux symptoms.
Q: What is the difference between total and partial fundoplication?
A: In total fundoplication, our surgeons wrap the top section of the stomach around the esophagus completely. In
partial fundoplication, the surgeon wraps the stomach only partially around the esophagus. Most patient who
choose a fundoplication will undergo a total (360o) wrap.
Q: Who is NOT a candidate for reflux surgery?
A: People with occasional heartburn and those who are under 18 or elderly may not be good candidates for reflux surgery. The best way to determine if surgery is right for you is to schedule an appointment with a
board-certified general surgeon at our Advanced Heartburn Center.