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There are four possible approaches to the treatment of Gastroesophageal Reflux Disease (GERD), including medication and surgery. Often, patients respond well to a combination of lifestyle changes and medication regimens.
Some patients do not find satisfactory relief from such methods and require surgical intervention. Other patients may opt for surgery as an alternative to taking medication for life.
Treatment Approach for GERD Patients
- Lifestyle and dietary changes.
- Drug treatment.
- Endoscopic therapy.
- Surgery.
Lifestyle and Dietary Changes
The first step to treating GERD is to change your lifestyle and diet. Certain foods make reflux worse. Suggestions to help alleviate symptoms include:
- Losing weight if the patient is overweight, of all the lifestyle changes that can be made, this is the most effective.
- Avoiding foods that can increase acid levels in the stomach such as caffeine.
- Avoiding foods that can decrease pressure in the lower esophagus, such as fatty foods and alcohol.
- Avoiding foods that affect peristalsis (muscle movement in the patient's digestive tract), such as coffee, alcohol and acidic liquids.
- Avoid foods that can slow down gastric emptying.
- Do not eat large meals.
- Stop smoking.
- Do not lie down immediately after eating.
- Elevate the head level when lying down.
TIF and Other Endoscopic Therapies
Another option for treating GERD is transoral incisionless fundoplication (TIF). TIF is considered more effective due to shorter treatment time, less pain and faster recovery than laparoscopic surgery. The procedure uses a special TIF device to create a passageway for imaging instruments such as an endoscope or a flexible tube that is inserted into the body.
The doctor will use tweezers and fasteners beforehand to repair or recreate the valve. It functions as a natural barrier to reflux.
Currently, there are clinical trials testing the efficacy of endoscopic therapy for GERD using an endoscopic suture machine with the aim of placing sutures in the abdomen to increase the anti-reflux barrier.
Surgery for GERD
If symptoms do not improve with lifestyle changes or drug therapy, patients may be candidates for surgery. Some patients prefer the surgical approach to reflux disease is to strengthen the anti-reflux barrier.
During a procedure known as Nissen fundoplication, the surgeon wraps the upper part of the patient's stomach around the lower esophagus. The aim is to increase the anti-reflux barrier and can provide permanent relief from reflux. The doctor will perform this surgery using the laparoscopic method which is less invasive and has a shorter recovery time.
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