Many people live with GERD (gastroesophageal reflux disease) without realizing it. GERD is more than occasional heartburn that improves with antacids. It often causes burning in the chest or throat, a sour or bitter taste in the mouth, regurgitation when lying down, or symptoms that occur several times a week. When medications stop providing relief, it may be time to consider other options.
Common Medications for GERD
Most patients with GERD start with medications that reduce stomach acid. Some are available over the counter, while others require a prescription. These medications are typically the first step in treatment.
H2 Blockers
H2 blockers reduce acid production and are often taken as needed for symptoms. Common examples include:
- Pepcid AC (famotidine)
- Tagamet (cimetidine)
- Ranitidine has largely been removed from the market
Proton Pump Inhibitors (PPIs)
PPIs are stronger acid-reducing medications and are usually taken daily, even if symptoms are not present. They are often more effective for frequent or severe reflux. Examples include:
- Prilosec (omeprazole)
- Prevacid (lansoprazole)
- Nexium (esomeprazole)
- Protonix (pantoprazole)
When Medications Are No Longer Enough
If symptoms continue despite appropriate use of PPIs and H2 blockers, GERD may not be just an acid problem. In many cases, the issue is mechanical. A weak or displaced valve between the esophagus and stomach can allow acid to reflux upward, even when acid production is reduced. When this happens, surgical treatment may be appropriate.
Testing Before Considering Surgery
Before surgery is recommended, a thorough evaluation is performed to confirm GERD and rule out other conditions that can cause similar symptoms. Two important tests are commonly used:
- Upper endoscopy with Bravo pH testing: Measures acid exposure in the lower esophagus over time and allows the surgeon to check for inflammation, Barrett’s esophagus, or a hiatal hernia.
- Esophageal manometry: Evaluates how well the muscles of the esophagus function. Poor coordination or weak contractions can mimic reflux symptoms and influence treatment options.
Surgical Treatment for GERD
If GERD is confirmed, surgery may be recommended. The most common procedure is a fundoplication, which strengthens the valve between the stomach and esophagus by wrapping part of the stomach around the lower esophagus. This helps prevent acid and food from refluxing upward. If a hiatal hernia is present, it is repaired during the same operation. At Kolachalam and Tindal Surgery, we tailor surgical treatment based on each patient’s anatomy, test results, and symptoms.
Lifestyle Changes That Can Help
Lifestyle modifications can improve symptoms and complement medical or surgical treatment:
- Weight loss, if applicable
- Avoid trigger foods such as chocolate, alcohol, spicy foods, coffee, mint, and tomato-based foods
- Elevating the head of the bed
- Regular physical activity
- Avoiding smoking
When to Seek Care
If you experience frequent heartburn, regurgitation, or GERD symptoms that do not improve with medication, further evaluation may be helpful. We have extensive experience in hiatal hernia surgery and can tailor the best management plan for your case.
Contact Kolachalam and Tindal Surgery at (248) 662-4272 to schedule a consultation and learn more about your treatment options.