Gerd treatment & lifestyle modifications

gerd-treatmentGastroesophageal Reflux Disease (GERD)

• Hiatal hernia. There is a hole in the diaphragm through which the oesophagus enters the abdominal cavity. Normally the entire stomach is below the diaphragm. Sometimes a part of the stomach enters the hole in the diaphragm. This is known as hiatal hernia.
Hiatal hernias are found in approximately 50 per cent of people over the age of 50.  Although the majority of people with hiatal hernias do not have GERD, the majority of people with GERD have hiatal hernias.


The presence of tvpical svmptoms is usually sufficient to make the diagnosis and begin treatment.  Patients with a history of heart disease or with multiple risk factors for heart disease (older age, diabetes, smoking, high blood pressure and/or history of heart disease in family members) may need evaluation to establish that the discomfort is not the result of heart problems.


In gastrointestinal endoscopy the inner lining of the oesophagus and stomach is viewed to determine whether the refluxed acid has produced any tissue damage.  It is done

• in patients of GERD who have unexplained weight loss or vomiting, difficulty in swallowing, evidence of bleeding from gastrointestinal tract or anaemia, to rule out other causes which may present with similar symptoms.

• if GERD symptoms start after the age of 40.

• in patients who do not respond to the standard treatment of GERD.


The mainstays of the treatment for GERD are lifestyle modifications and, if necessary, medicines to decrease the amount of acid in the stomach.

Lifestyle Modifications

Rest and Sleep:

• Do not lie down immediately after a meal.
• Allow 2-3 hours between eating and bedtime.
• Prop up the head of the bed 6 inches with blocks under the legs of the bed, it will be difficult for the stomach contents to enter into the oesophagus.

Foods to Avoid

• Alcohol
• Peppermint
• Chocolate
• All caffeinated drinks (coffee, tea, most of the cola soft drinks)
• Fatty foods

• Smoking
• Wearing cloths which are tight around the waist
• Overeating (weight loss may help GERD in overweight persons)


If lifestyle modifications fail to relieve the symptoms, medications are tried.  The commonly used medication groups are:

• Antacids medications.
They produce relief by reducing the acidity of the stomach contents.

• Prokinetic agents (e.g. metoclopramide, cisapride, mosapride, itopride).
They improve the motility of the intestines. The drug is to be taken
orally 30 minutes before lunch and dinner.

• H2 blockers like ranidine, famotidine and proton pump inhibitors like
omeprazole, pantoprazole, esomrezaole and rabeprzole reduce the acid production in the stomach.

Surgical Procedures

In up to 80 per cent of patients with moderate to severe GERD, recurrence of symptoms occurs when medical treatment is stopped. For such patients and patients who require large doses of medicines to remain symptom-free or are unable to stop medicines, surgical procedures to prevent reflux may be required.

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