Question: What is your remedy for GERD? I'm very concerned about my esophagus."
Dr. Hibberd's Answer:
Fortunately, GERD, known as gastro-esophageal reflux disease (not really a disease, but more correctly a condition), is fairly simple to manage in most instances.
It affects 25 percent of the adult population and increases in frequency as we age. We generally describe the management of this condition using acid blocking agents called H2 blockers (Zantac, Pepcid, Axid etc.) or stronger proton pump inhibitors (Prilosec, Nexium, etc.) since they are simple to use with minimal side effects. Antacids are usually used for occasional symptomatic use only and have little role in long-term management.
When reflux occurs, esophageal tissues are exposed to regurgitated or 'refluxed' acidic gastric contents. The throat does not have the protection that stomach tissue possesses, and is apt to be at risk for chronic inflammation, scarring, and strictures that eventually impair your ability to efficiently pass food to your stomach.
It may be a nuisance for most, and give bad breath to others, but can be life threatening for some. Untreated GERD can cause severe lung damage, not uncommonly seen as a source of wheezing and severe aspiration pneumonia (difficult to treat) in the very young and the elderly.
Rarely a condition known a 'Barrett's esophagus' is seen, which is known to lead to a high risk of esophageal carcinoma. While chronic reflux does not necessarily produce Barrett's esophagus, it is seen more frequently in the population of patients presenting with GERD.
This condition requires periodic endoscopic surveillance and consideration for preventative surgical management.
While GERD is often seen in association with a hiatal hernia, surgical correction of this area does not always correct the reflux condition totally, or in some cases over-corrects for this, resulting in difficulty passing food into the stomach.
GERD is generally regarded managed as a medical (lifestyle and pharmaceutical) not surgical condition. Surgical procedures are not worth the risk given the complication and recurrence rates unless you condition is at least moderately severe and unmanageable by other means.
Often simple weight management accompanied by small frequent meals will significantly reduce reflux for most people. Raising the head of your bed may help decrease passive reflux while you sleep. Avoidance of eating or drinking immediately before bed may be helpful. Try to finish your evening meal several hours before bedtime.
Some foods, conditions, and some drugs are known to increase reflux: nicotine, caffeine, alcohol, estrogen, progesterone, nitrates, calcium channel blockers, chocolate, obesity, and high-fat foods.
However, don’t stress out on this condition. Manage it wisely in conjunction with good professional guidance and you will be surprised to see how well even severe esophageal reflux will respond to seemingly simple measures.
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