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Home > Medical Reference > Encyclopedia (English)

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Gastroesophageal reflux disease - Treatment

Alternative Names

Peptic esophagitis; Reflux esophagitis; GERD; Heartburn - chronic

Treatment:

General measures include:

  • Avoiding alcohol and tobacco
  • Avoiding dietary fat, chocolate, caffeine, peppermint, onions, garlic, citrus juices, and tomato products (which may cause lower esophageal pressure)
  • Avoiding lying down after meals
  • Sleeping with the head of the bed elevated
  • Taking medication with plenty of water
  • Weight reduction

Medications that alleviate symptoms include:

  • Over-the-counter antacids after meals and at bedtime, although they do not last very long
  • Histamine H2 receptor blockers, mostly for milder symptoms
  • Promotility agents
  • Proton pump inhibitors, which may take up to four days to relieve symptoms
Anti-reflux operations (Nissen fundoplication and others) may help a small number of patients whose symptoms do not go away with lifestyle changes and drugs, Even after surgery, many patients still need to take drugs to relieve their symptoms. There are also new therapies that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach) for reflux.

Expectations (prognosis):

The majority of people respond to nonsurgical measures, with lifestyle changes and medications. However, many patients need to continue to take drugs to control their symptoms.

Complications:

  • Barrett's esophagus (a change in the lining of the esophagus that can increase the risk of cancer)
  • Bronchospasm (irritation and resulting spasm of airways due to acid)
  • Chronic pulmonary disease
  • Esophageal ulcer
  • Hoarseness
  • Inflammation of the esophagus
  • Stricture (a narrowing of the esophagus due to scarring from the inflammation)

Calling your health care provider:

Call your health care provider if symptoms worsen or do not improve with lifestyle changes or medication.

Also call for any of the following symptoms:

  • Bleeding
  • Choking (coughing, shortness of breath)
  • Early satiety (feeling filled up quickly when eating)
  • Frequent vomiting
  • Hoarseness
  • Loss of appetite
  • Trouble swallowing (dysphagia) or pain with swallowing (odynophagia)
  • Weight loss
  • Reviewed last on: 9/7/2008
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Wang, KK, Sampliner, R E. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. Am J Gastroenterol. 2008;103(3):788-97.

Khan, M, Santana, J, Donnellan, C, Preston, C, Moayyedi, P. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev(2). 2007;CD003244.

Wilson, J F. In the clinic. Gastroesophageal reflux disease. Ann Intern Med. 2008;149(3): ITC2-1-15; quiz ITC2-16

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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