The doctor often will start you out with over the counter medications and gradually resort to other more intensive treatments if OTC medications are not effective. Other treatments for GERD can include:
- H2 receptor antagonists
- Proton pump inhibitors or PPIs
If symptoms respond to medicines, these medicines may be the only treatment plan you need for either short-term or long-term usage.
Antacids – These drugs offset stomach acid effects in the stomach and esophagus. Since antacids can interfere with the effects of other medicines you are taking, antacids are not to be used along with other medications. Antacids can also cause damage on the coatings of other tablets. You can seek advice from your pharmacist or doctor on the benefits and disadvantages of antacids.
Alginates are different forms of antacids and they act to form a kind of coating to protect your esophageal and stomach linings from the damaging consequences of stomach acid.
Proton pump inhibitors – These treatments are used if OTC medicines fail to address GERD. These drugs work by lessening acid content in your stomach.
To prevent side effects, the doctor will often recommend you take the lowest dose possible of PPIs or the least amount of dosage that will be good enough to control GERD symptoms. They can be taken for short term or a long term usage.
H2-receptor antagonists – These drugs are recommended by doctors along with PPIs for about half a month, or in lieu of PPIs. H2-receptor antagonists inhibit the effect of histamine, a chemical that is vital for stomach acid production. This then helps lessen stomach acid content.
Certain H2RAs are offered as OTC drugs and are used in lower dosages than their prescription types. Talk to your pharmacist or doctor if these medications are the right treatments for you.
Prokinetics – Prokinetics work by accelerating the emptying of your abdomen, thereby, minimizing the likelihood of acid reflux. Some takers of prokinetics experience what is called extrapyramidal symptoms. These symptoms affect the nervous system. They include:
- Negative changes in body posture
- Slurred speech
- An involuntary habit of sticking your tongue outside your mouth
- Difficulty in fully opening out your mouth
- Muscle spasms
When you exhibit any one of these symptoms contact your doctor immediately. He usually will have your intake of these drugs discontinued. People below 20 years of age are usually not prescribed prokinetics because they have a higher risk than any age group of developing extrapyramidal side effects.
This procedure is often suggested in a patient who has no positive response to the other aforementioned treatments. You can also request for surgery when you experience troublesome and persistent symptoms but have no desire to be under drugs for a long period of time.
GERD surgical procedures can include:
- Endoscopic radiofrequency ablation
- Endoscopic injection of bulking agents
- Endoscopic augmentation with hydrogel implants
- Endoluminal gastroplication
- Laparoscopic nissen fundoplication
Endoscopic radiofrequency ablation – In this surgery the surgeon inserts a balloon down the endoscope to the area where the gastroesophageal junction is located and then inflates the balloon. Electrodes outside the balloon generate tiny amounts of heat. The heat causes small tissue scars in your esophagus to develop. This results in the narrowing of the esophagus making it difficult for the stomach acid to escape the stomach.
Endoscopic injection of bulking agents – In this surgery, an endoscope is used by the surgeon to locate the gastroesophageal junction. A catheter then is inserted into the endoscope which serves as a way to inject a solution of liquid and plastic into the gastroesophageal junction. This procedure restricts the junction making stomach acid difficult to escape into the esophagus.
Endoscopic augmentation using hydrogel implants – Follows the same technique as endoscopic injection, but instead of using a plastic and liquid solution, it applies hydrogel that is very much like human tissue to shrink your gastroesophageal junction.
Endoluminal gastroplication – This procedure involves the use of an endoscope by the surgeon to scatter a number of folds or pleats into the lower esophageal sphincter. The pleats limit the opening of the lower esophageal sphincter and help bar stomach acid from leaking into the esophagus.
Laparoscopic nissen fundoplication or LNF – This is probably the most commonly used surgical procedure to treat GERD symptoms. In this procedure the surgeon creates a number of incisions in your stomach. The surgeon fills your stomach then with carbon dioxide gas. Next the surgeon wraps the upper part of your stomach around your esophagus whilst stapling it in place. This procedure tightens up your lower esophageal sphincter making it hard for the acid from refluxing into the esophagus.
General anesthesia is used for LNF procedures and the procedure typically takes an hour to an hour and a half to complete.
Acupuncture – People who have undergone acupuncture therapy have experienced stability of their digestive system without the benefit of medications or surgery. One particular benefit of acupuncture is it helps regulate stomach acid production which prevents the development of GERD. Acupuncture is a unique ancient Chinese treatment that uses hair thin needles inserted at strategic points in the body to heal a certain type of malady. Acupuncture may not be effective for everyone and you may need to talk to your doctor to know if acupuncture is right for you.
Relaxation therapies – Relaxation techniques like tai chi, meditation, yoga or even biofeedback can help dissipate the symptoms and signs of GERD. You can consult with your doctor as to what relaxation techniques are good for you.
Herbal remedies – Very helpful herbal products like marshmallow, chamomile, slippery elm and licorice among dozens of other herbs can neutralize the mild and more severe side effects of GERD. You need to consult with a doctor or licensed herbalist to see what herbs are good for you and what herbs will not disrupt the effects of present medications you are taking as well as to know the side effects of certain plants.