Senin, 02 Januari 2012

Treatment Options for Acid Reflux

The term "acid reflux" refers to one of two disorders - gastroesophageal reflux disease (GERD), which occurs when stomach acid seeps into the esophagus, and laryngopharyngeal reflux (LPR), in which the contents of the stomach flow into the upper aero-digestive tract. The former is more likely to produce heartburn, and so the latter form is often referred to as "silent reflux." If either type is not treated early, the lining of the esophagus can erode.

Different forms of acid reflux treatment exist for each of the two forms discussed above, but both involve changes in lifestyle as well as drugs and surgery. Drugs commonly prescribed to treat GERD include sucralfate, which heals the esophagus; antacids to help reduce acidity (but see below); mosapride, which is commonly used outside the United States; alginic acid; and baclofen.

Sometimes surgery is necessary. A special surgical procedure known as the Nissen fundoplication has been developed to treat GERD; it involves wrapping the upper section of the stomach around the part of the esophagus that immediately connects with it. The two ends of the stomach are then stitched together. Sometimes, the wrapping is not done completely around the tube. Surgical removal of the vagus nerve (vagotomy) is no longer used, having been replaced by drug therapy.

Eleven years ago, a device called the Endocinch, using stitches to strengthen the esophageal muscle, was approved by the FDA to treat GERD, but it soon fell out of use due to disappointing results. The NDO Surgical Plicator is no longer sold either.

Lifestyle habits which can reduce the likelihood of developing acid reflux fall into two categories: diet and sleeping position.

Certain foods, such as chocolate, fatty foods, and drinks that contain alcohol and caffeine, can aggravate the symptoms of GERD, and so should be reduced- and the same with calcium carbonate- based antacids. Just as important, one should also watch the size of one's meals and also time them. This means not eating too much at once, preferring five small meals to three big ones; not going to sleep immediately after a meal; and drinking plenty of water throughout the day, including just before and just after exercise to avoid dehydration. Smoking should also be avoided. Antacids are sometimes prescribed to treat the disease, but their effects are only temporary.

Good sleeping habits that can reduce heartburn include sleeping on the left side, rather than on the right, and having extra pillows to elevate the body, thus allowing gravity to play its part in making acids flow downward through the esophagus.

Treatment of LPR also involves weight reduction and dietary modification, and may, failing all else, require a Nissen fundoplication.

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