GERD, Heartburn, and Acid Reflux Treatment Is Easy!
One of the questions I’m often asked is whether or not acid reflux treatment with lifestyle changes and dietary changes is a realistic approach, or whether treatment using prescription drugs is necessary.
The answer is that acid reflux remedies can be very effective, and are well worth trying. And, yes, sometimes medical help is needed. This is because acid reflux symptoms, heartburn, and GERD signs and symptoms (GERD stands for “gastroesophageal reflux disease”) are actually quite variable; some people obtain relief quite quickly and easily, while others have a problem that seems to be more resistant to treatment of any kind.
This means that you may have to try a number of approaches until you discover the one that works best for you.
Some therapists believe that one of the most effective methods of treating acid reflux symptoms is to keep a food diary in which you note everything you eat and the consequences you experience. This allows you to eliminate from your diet with foods which appear to cause symptoms of GERD or acid reflux.
The usual culprits include alcohol, smoking tobacco, heavy meals, fatty foods, spices, caffeine, carbonated drinks, citrus products, acidic juices, acidic condiments like vinegar, and possibly other items. Keeping a food diary will allow you to identify these. But there are many other acid reflux home remedies that are widely recommended and often help clear the symptoms of heartburn and GERD.
The best approach to a complete lifestyle package for the control of GERD and acid reflux is described in the eBook Heartburn No More: you can discover more about this if you look at the feature in the right-hand column of this page.
Treatment: Acid Reflux Remedies & Home Remedies
In general, advice about acid reflux remedies can be summarized as follows:
1) Eat smaller meals, and have more of them. Overloading your stomach is likely to trigger the dysfunction of the lower esophageal sphincter which results in acid being allowed into the esophagus. So two or three large meals every day should be replaced by, say, four or five smaller ones.
2) Don’t eat for at least two or three hours before you lie down. We know that people with gastroesophageal reflux disease are much more likely to experience reflux when lying down and standing up. It follows that if you have a heavy meal, or indeed anything, near to your bedtime, you’re precipitating the chances of experiencing reflux. And you want to avoid that night, if possible.
3) If you need to take rest during the day, sleep sitting in a chair, perhaps reclining slightly for a nap. Adjust your clothing so that you’re not wearing anything tight around your stomach area. Certainly, tight-fitting clothes can increase the pressure in the abdomen when you bend or move about, and we know that’s one cause of acid reflux.
4) If you’re overweight or even obese, it’s important to lose weight, because the pressure in your abdomen is going to be much higher. This means that when you bend or move about the contents of the stomach are more likely to reflux into the esophagus.
Admittedly, losing weight isn’t always easy, but there’s a balance to be found between your tolerance for discomfort and your willpower about losing weight. And, as you can easily see, all these lifestyle modifications are a cheap form of acid reflux treatment!
5) It’s also worth checking with your doctor to see if any of the medication you’re taking might be responsible for acid reflux of stomach problems. Certainly, things like anti-inflammatories, NSAIDs (i.e. non-steroidal anti-inflammatories), can cause stomach problems.
Medication As Treatment For Acid Reflux
You may find that lifestyle changes and over-the-counter medications are sufficient to eliminate the symptoms of acid reflux. The simplest over-the-counter medications you can obtain are antacids, such as Maalox, Rennies, Mylanta, and so on.
These are simple alkaline compounds that react with the acid to neutralize it. Unfortunately, they can cause diarrhea or constipation, and they are not really an effective long-term solution, even though they can serve as a powerful treatment in the short-term. (Image courtesy of sattva / FreeDigitalPhotos.net)
There are a number of other products which you may already know about. Products like Gaviscon coat the inside of the stomach and reduce the symptoms of acid reflux.
Then there are hydrogen blockers, which were the first so-called “blockbuster” drugs, and which proved very effective in helping people with excess stomach acid. These compounds are still available, many of them over the counter; they include Pepcid, Tagamet, and Zantac. (Famotidine, Cimetidine, and Ranitidine, respectively).
These products can be an effective treatment for heartburn and gastroesophageal reflux disease, but like all medications, they may have side effects.
The latest generation of medication available to treat acid reflux is the proton pump inhibitors such as Prilosec, Prevacid, and others. These tend to be more effective at stopping the production of stomach acid, but they don’t treat acid reflux effectively in all cases, and they do have some side effects, about which you can read more information below. However, they are now regarded as the reflux treatment of choice.
Acid Reflux Treatment: Surgery
If the treatments mentioned above aren’t effective, a surgical procedure known as the Nissen fundoplication may be desirable.
This is actually the treatment commonly used for paraesophageal hiatus hernia, but it can also be used in other situations where medication for GERD is either ineffective or undesirable. It was developed by Dr. Rudolph Nissen in 1955 and has gained popularity ever since.
It’s called a fundoplication because the gastric fundus – which simply means the top part of the stomach – is wrapped around the bottom part of the esophagus and stitched into place. This has the effect of reinforcing the lower esophageal sphincter; in addition, the hiatus through which the esophagus passes into the stomach is tightened up with sutures. In the classic procedure, the gastric fundus is taken all the way around the esophagus and stitched in place, although partial fundoplication is also possible, especially in cases where achalasia* is present.
The effect of the surgery, which is usually performed laparoscopically, is to prevent acid reflux, because when the stomach contracts, it seals off the entrance to the esophagus. Unfortunately, there can be side effects, particularly gas bloat, but these tend to reduce with time. In general, fundoplication is regarded as both an effective and safe procedure.
Video About Treating Acid Reflux
*Achalasia is an esophageal motility disorder, which affects the lower esophageal sphincter causing it to lack of muscle tone. The motility of the esophagus is reduced so peristalsis doesn’t function correctly. This can make it difficult to swallow, the symptoms of achalasia include difficulty swallowing, regurgitation chest pain.
Side Effects Of Acid Reflux Treatment With Drugs
When they first came out, some experts thought that PPIs might increase the risk of stomach cancer. This was untrue, but people may take PPIs on a daily basis for years, so it’s important to know if there are any other interactions.
1) Interaction with clopidogrel (marketed under the names of Ceruvin, Clopilet, and Plavix).
Clopidogrel discourages blood clots and helps prevent heart attacks and stroke for heart patients. But clopidogrel increases the risk of gastrointestinal bleeding. A PPI prescribed with clopidogrel makes blood clots less likely to form… but unfortunately PPIs — and omeprazole in particular — inhibit an enzyme crucial to the activation of clopidogrel. In 2009, the FDA warned that patients taking clopidogrel should avoid taking omeprazole because PPIs cut clopidogrel’s effectiveness by 50%.
However, two studies published in 2010 showed no increase in a heart attack or stroke among those taking a PPI with clopidogrel. This acid reflux treatment drug did seem to reduce the risk of gastrointestinal bleeds. Opinions vary, however: FDA officials pointed to flaws in the interpretation of the trial and stuck by the agency’s warning. The American Heart Association, the American College of Cardiology, and the American College of Gastroenterology recommended an individual risk-benefit approach for each patient. For example, older people, those taking warfarin, and those with a prior gastro-bleed, among others may need a PPI.
Another strategy might be taking a PPI and clopidogrel at separate times. PPIs work best if they are taken first thing in the morning,so clopidogrel could be taken at night.
Fracture risk. Some studies have linked PPIs and a higher risk of fracture of the hips, but the evidence is not conclusive. Even so, the FDA decided in 2010 to issue a warning about it. Some research shows that PPIs may reduce the absorption of calcium from the duodenum, causing osteoporosis, and a higher risk of fracture. Though small, the risk may be another reason for not taking a PPI unless essential.
Pneumonia risk. Studies of treatment of acid reflux with PPIs suggest people taking PPIs seem to be more likely to get pneumonia – both people living in the community and hospital patients. This appears to be because reduced stomach acid allows the bacteria count can go up. And then treatment for acid reflux allows bacteria-laden stomach contents to move up the esophagus and into the trachea and lungs, causing pneumonia.
C. difficile risk. Clostridium difficile infections develop in hospitals after people are prescribed antibiotics. Such infections cause diarrhea but can also become life-threatening. There is a link of some kind between PPI use and C. difficile infection: experimental evidence indicates that PPIs may make the gut environment more favorable to C. difficile bacteria.
Iron and B12 deficiency. Stomach acid helps the body absorb iron and vitamin B12. An unintended consequence of PPIs might be deficiencies of this vitamin and mineral, but research has shown that the effect is mild, so this aspect of acid reflux treatment is not a cause for concern.