Treatment options for people who suffer from GORD vary widely depending on the severity and symptoms of their disease, however, there are currently three primary means of treating GORD: lifestyle changes, medical therapy and surgical intervention. Always consult your physician when considering treatment options.
Infrequent heartburn may be controlled by lifestyle changes such as weight loss, smoking cessation and eating modifications. Taking the following steps may aid in reducing the frequency and severity of reflux episodes:
Taking steps such as these may help to reduce the symptoms associated with infrequent reflux, however, for patients who have moderate to severe GORD, lifestyle changes alone may not completely relieve symptoms.
Medications used to treat GORD fall into three categories: antacids, H2 Blockers and Proton Pump Inhibitors (PPI’s). These medications are designed to control or suppress acid production in the stomach. They do not address the cause of reflux and do not prevent reflux. It is important to note that each of these drugs may require lifetime therapy; symptoms may return shortly after a patient discontinues their use.
Antacids are drugs that neutralize stomach acid. While effective for immediate, short-term relief, antacids are typically not effective in preventing chronic heartburn. Common antacids include: Maalox®, Mylanta®, Tums®, Alka-Seltzer®, and Rolaids®.
H2 (histamine) inhibitors act on the acid producing cells (parietal cells) of the stomach. H2 blockers prevent histamine from stimulating the parietal cell, reducing the amount of acid each cell produces. H2 blockers work for 8-12 hours. Taking an H2 blocker in the morning may not prevent acid production and heartburn later in the day. Common H2 blockers include: Tagamet®, Zantac®, and Pepcid®.
Proton Pump Inhibitors (PPI’s) are the most commonly prescribed medication for the treatment of heartburn and acid-related disorders. They work by blocking the site of acid production in the parietal cells of the stomach, these acid producing sites are called proton pumps. Proton Pump Inhibitors are generally more potent at suppressing acid secretion and have a longer duration of efficacy than H2 blockers. Common PPI’s include: Nexium®, Prevacid®, and Protonix®.
Anti-reflux surgery is performed through open or laparoscopic incisions in the abdominal wall. Currently, the standard of care for surgical treatment of GORD is the Fundoplication procedure. The Fundoplication procedure involves wrapping a portion of the stomach around the oesophagus to reinforce the weakened Lower Oesophageal Sphincter.
While typically effective, the procedure has several shortcomings that have limited its use: