Heartburn Center in Birmingham, AL
- The first step in treating mild acid reflux often includes lifestyle and diet modifications:
- 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.
- Decrease portion sizes at mealtime
- Eat meals at least two to three hours before bedtime and go to sleep with an empty stomach
- Elevate the head of your bed four to six inches or use a wedge
- Lose weight
- Exercise with an empty stomach
- Avoid tight clothing
- Stop smoking
- Avoid stress
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.
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:
- You continue to suffer from persistent heartburn, or other reflux symptoms, while taking medication
- You are concerned about or develop adverse side effects such as osteoporosis as a result of taking medication
- Symptoms return when therapy is stopped
- Your esophagus is damaged (bleeding/stricture)
- You prefer not to take lifelong medication or feel you cannot afford to do so
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.
If your GERD (acid reflux) symptoms are severe and cannot be eased with medicine or lifestyle changes, your doctor may suggest surgery. Surgery for GERD is called fundoplication or Nissen fundoplication.
In many cases, surgery can lead to long-term control of acid reflux. If a hiatal hernia is causing GERD symptoms, your surgeon may also repair the hernia during this operation. A hiatal hernia occurs when part of your stomach pushes up into your diaphragm muscle.
During GERD fundoplication surgery, your doctor wraps the upper curve of your stomach (fundus) around the esophagus (tube that carries food and liquids from your mouth to your stomach). Your surgeon will then stitch it into place. This strengthens the valve between your esophagus and stomach, which stops acid from rising into the esophagus as easily.