Acid Reflux Disease: Diagnosis And Treatment

  

  In my previous article on Gastroesophegal Reflux Disease (Acid Reflux Disease), I talked about what Acid Reflux Disease is, what causes it, some common risk factors and symptoms. In today's article, I shall be discussing about the different methods of diagnosing and treating a case of Acid Reflux Disease.



DIAGNOSIS OF GERD

    First off, I will do a rundown of medical tests which can be used to diagnose the Acid Reflux Disease. They include;
  1. X-ray of your upper digestive system: With this test method, the doctor will have to see a silhouette of your esophagus, stomach and upper intestine. This is made possible using an X-ray machine after you drink a chalky liquid. This liquid coats and fills the inside lining of your digestive tract.
    You may be asked to swallow a barium pill, this will help diagnose if there is a narrowing of the esophagus.
  2. Esophageal manometry: This test method simply measures the coordination, force exerted and rhythmic contraction in your esophagus when you swallow.
  3. Upper endoscopy: With this test method, a thin but flexible tube with a light and camera (endoscope) would be put down your throat to examine the inside of your stomach and esophagus. An endoscopy can detect an inflammation of the esophagus (esophagitis) or it could be used to collect a tissue sample (biopsy). This tissue sample would be tested for other complications of the esophagus.
  4. pH Monitoring: With this method, the doctor inserts a monitor into your esophagus to identify when and for how long stomach acid regurgitates there. The monitor might be a thin, flexible tube (catheter) that's threaded through your nose into your esophagus, or a clip that's placed in your esophagus during an endoscopy and that gets passed into your stool after about two days.

TREATMENT OF GERD

    GERD can be treated in several ways including over the counter drugs, prescription drugs and in worst cases, surgery. 
    Over the counter drugs and dietary changes is the first way of treating GERD. Prescription drugs become necessary in severe cases when damage to the esophagus is to be prevented. Surgical method could be recommended by the doctor if medication does not work.
    Before I begin talking about over the counter drugs, I will like to mention that there are  a couple of home remedies to Acid Reflux Disease that could be used to reduce the incident of a heart burn. They include;

  • Eat smaller food frequently throughout the day.
  • Avoid smoking as this damages the lower esophageal sphincter (LES).
  • Avoid fatty or greasy food. Consume more protein rich food, this will keep you full and prevent you from overeating.
  • If you're obese, work out to lose at least 2 pounds per week. Excess fat especially in the abdominal area puts your stomach under pressure.
  • Avoid tight clothing, especially belts and pants. These put too much pressure on the stomach and increases your risk of a heart burn.
  • Do not eat 3 hours to bedtime.
  • Elevate the head of your bed 6 inches with blocks. Gravity helps prevent reflux.
  • Reduce the intake of alcohol.


OVER THE COUNTER DRUGS

1. Antacids: These are medications that neutralize stomach acids. They are more effective when taken 1 hour before meals and at bedtime. This is because they neutralize acids that are already present in the stomach. Example of an antacid is Gaviscon. Prolonged use of antacids can lead to diarrhoea and some kidney diseases due to build up of magnesium in the body.

2. Histamine-2 receptor blockers (H2-blockers): These are medications that prevent the production of stomach acids. They are only effective when taken an hour before every meal, this is because they do not affect acid already present in the stomach.
    Common examples of H2-blockers include cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), and nizatidine (Axid). Stronger versions of H2-blockers are available only on prescription. 

3. Proton Pump Inhibitors (PPIs): These are medications that inhibit the production of enzyme that produces stomach enzyme. They stop acid production more completely than H2-blockers. Examples of over the counter PPIs include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC, Zegerid OTC).

 

PRESCRIPTION DRUG 

1. Prescription-strength H-2-receptor blockers: They include prescription strength
famotidine (Pepcid), nizatidine and ranitidine (Zantac). Prolonged use can put patient at risk of bone fracture and a deficiency in vitamin B12 (Cobalamin).

2. Prescription-strength proton pump inhibitors: These include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant). These medications might cause diarrhea, headache, nausea and vitamin B-12 deficiency. Chronic use might increase the risk of hip fracture.

3. Prokinetics or promotility agents: These are medications than can help strengthen the LES, empty your stomach faster, and reduce acid reflux. Examples include Reglan and Urecholine. 

4. Coating Agent: This medication coats mucous membranes and sores to provide an additional protective barrier against stomach acid. Example include Sucralfate (Carafate).


SURGERY

    Surgery is always the last option in the treatment of GERD. A change of lifestyle, diet, over the counter drugs and prescription drugs would first of all be tried and if they fail, surgery becomes the last option. There are two surgical methods used in correcting Acid Reflux Disease.

Fundoplication
Fundoplication

    Fundoplication is the most used method. It involves using the top of your stomach to wrap around your Lower Esophegeal Sphincter. This is done to strengthen the LES, prevent a reflux and repair a hiatal hernia. Surgeons perform this procedure through either an open incision in the abdomen or chest or with a lighted tube inserted through a tiny incision in the abdomen. Like all surgical procedures, fundoplication does not always work and can have complications.

LINX Method

     The latest method is called the LINX method and is a less invasive method than the Fundoplication method. This involves the surgical placing of a LINX device around the outside end of the lower end of the esophagus. 
    The ring is made up of titanium beads held together by titanium wires. The force of attraction between the beads is strong enough to hold back a reflux but weak enough to let food pass.
    You shouldn't get the LINX device if you're allergic to certain metals, and once you have a LINX device you shouldn't get any type of MRI test.

    In conclusion, if you're diagnosed of the Acid Reflux Disease, the home remedy is best and the first thing to try. You are advised to see a medical expert to recommend what kind of treatment or drug will be best for you.


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