There are a host of medications available both over the counter and by prescription that all function the same way. These GERD treatments either neutralize or decrease the production of stomach acid.
Common GERD Treatments
There are a variety of GERD treatments available. The most common treatment of GERD is taking medications to improve symptoms. There are a host of medications available both over the counter and by prescription that all function the same way. These GERD treatments either neutralize or decrease the production of stomach acid. These drugs include antacids such as Tums, H2 blockers such as Zantac and Pepcid and the most powerful acid suppressants called PPIs (Nexium, Prilosec and others.) The medications do not address the actual cause of reflux, which is the damaged LES. The reflux continues, but it no longer contains acid. This controls symptoms in most people. These medications must be taken for life and have both short and long term side effects. Since the valve is not improved, these drugs often fail and other methods are required.
Another approach to the treatment of GERD is to directly restore the function of the damaged LES. Restoring LES function can stop the reflux; eliminate symptoms as well as the need for medications. There are several procedures intended to accomplish this.
Minimally Invasive Surgical GERD Treatments – Nissen Fundoplication & LINX Procedure
The “gold standard” to which all antireflux procedures are compared is the laparoscopic Nissen fundoplication (Nissen). This GERD treatment is a minimally invasive surgical procedure that is performed under general anesthesia through 5 small incisions 1/4 to 1/2 inches long. A slender scope (laparoscope) is inserted into the abdomen that produces a high-resolution image on a monitor, which the surgeon carefully observes as he performs the procedure through the small incisions. The procedure involves recreating a functional valve by wrapping part of the stomach around the lower esophagus at the site of the LES. The procedure takes approximately 1-2 hours and the hospital stay is usually 1 night. Most patients are back to light, “every day” activity within a week. A successful laparoscopic Nissen fundoplication stops the reflux approximately 80-85% of the time, and 90% of patients are satisfied with the procedure after 5 years. Side effects can include the inability to belch or vomit in about 30%, as well as excess gas and bloating. A small number have swallowing difficulty. The Nissen stops the reflux with greater reliability than all existing GERD treatments procedures. Experienced surgeons who perform the Nissen obtain excellent results.
The Transoral Intraluminal Fundoplication (TIF procedure) is one of the GERD treatments that are performed without incisions. Under general anesthesia a special scope passed orally into the stomach is used to place small plastic fasteners, which attempts to recreate the dysfunctional valve from the inside of the stomach. It has been available for several years and improves GERD symptoms in most patients. It does not stop the reflux but decreases medication requirements in most patients. There are few side effects. Results have been variable.
LINX Reflux Management System
The newest of GERD treatments now available is called the LINX Reflux Management System. This is performed using the same minimally invasive technique as the Nissen, however it is much less complex. A specially designed “bracelet of magnetic beads” is placed loosely around the esophagus, augmenting the damaged LES. As food passes, the magnetic beads separate allowing the food to pass and then closes thereafter, preventing reflux. The procedure takes approximately 30 minutes and the hospital stay is overnight. Full activity and a normal diet are resumed immediately. Reflux is stopped in most patients and the side effects are minimal. Presently, this procedure is only available at select centers. The Heartburn Treatment Center was selected as one of the first places in the U.S. to offer this revolutionary heartburn treatment procedure.
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