last 12 years i am suffering GERD problem, and took various medication in English,ayurveda,Homeo.but still the same problem.i met 15 gastro doctors, and did various test. still i am taking daily RAZO-20 tablets. please anyone suggest good remedy for this problem.I am working in Muscat petrochemical area for the last 15 years. You really need to adjust your diet to exclude chocolate, caffeine, spicy foods, anything with acid, heavy foods that are greasy, and the big culprit is eating too large of meals.
Also, talk to your doctor about using a newer drug called Aciphex. I've had GERD for 14 years and this is the first drug that doesn't have ANY side effects and controls my symptoms..... Treatment
Whether you have mild, moderate or severe heartburn, many treatment options are available. The most common treatments involve medications, but surgical and other procedures also are available.
Over-the-counter remedies
If you experience only occasional, mild heartburn, you may get relief from an over-the-counter (OTC) medication and self-care measures. OTC remedies include:
* Antacids. Antacids, such as Maalox, Mylanta, Gelusil, Rolaids and Tums, neutralize stomach acid and can provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects such as diarrhea or constipation.
* H-2-receptor blockers. Over-the-counterH-2-receptor blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine Axid AR or ranitidine (Zantac 75), are available at half the strength of their prescription versions. Instead of neutralizing the acid, these medications reduce the production of acid. They don't act as quickly as antacids, but they provide longer relief. Take these medications before a meal that you think may cause heartburn because it takes them about 30 minutes to work. They're also effective in reducing reflux at night if taken at bedtime. H-2-receptor blockers can cause infrequent side effects, including bowel changes, dry mouth, dizziness or drowsiness. In rare instances they can also react dangerously with other medications.
* Proton pump inhibitors. These medications block acid production and allow time for damaged esophageal tissue to heal. Omeprazole (Prilosec) was previously available only by prescription, but now is available in an over-the-counter form for treatment of heartburn.
Prescription-strength medications
If you have frequent and persistent heartburn, you may have GERD, leading to an inflamed esophagus (esophagitis). GERD usually requires prescription-strength medication. Prescription medications can help reduce and eliminate GERD symptoms, as well as help heal an inflamed esophagus 鈥?the result of continual exposure to stomach acid. The main types of prescription drugs are:
* Prescription-strength H-2-receptor blockers. These significantly reduce acid production and have few side effects. They include prescription-strength Axid, Pepcid, Tagamet and Zantac.
* Prescription-strength proton pump inhibitors. These are long-acting and are the most effective medications for suppressing acid production. They're safe and have few side effects for long-term treatment (at least 10 years). To prevent possible side effects, such as stomach or abdominal pain, diarrhea or headaches, your doctor will likely prescribe the lowest effective dose. Prescription-strength proton pump inhibitors include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) and rabeprazole (Aciphex).
* Prokinetic agents. These don't reduce acid production. Instead, they help your stomach empty more rapidly and may help tighten the valve between the stomach and the esophagus. Because the prokinetic agents thus far sometimes cause serious side effects, researchers are working to develop safer versions.
Surgical and other procedures
Because of the effectiveness of medications, surgery for GERD is uncommon. However, it may be an option if you can't tolerate the medications, you can't afford their long-term use or your doctor determines that the medications are ineffective. Your doctor also may recommend surgery if you have any of these complications:
* Large hiatal hernia
* Severe esophagitis, especially with bleeding
* Recurrent narrowing (stricture) of the esophagus
* Barrett's esophagus, especially with progressive precancerous or cancerous changes
* Severe pulmonary problems, such as bronchitis or pneumonia, due to acid reflux
Before 1991, a procedure called open Nissen fundoplication was the surgery of choice for severe GERD. Today, doctors are able to perform the same surgery with similar success laparoscopically 鈥?through a few small abdominal incisions, instead of one large one. The advantages of laparoscopic surgery are a shorter recovery time and less discomfort.
Nissen fundoplication involves tightening the lower esophageal sphincter to prevent reflux by wrapping the very top of the stomach around the outside of the lower esophagus. During laparoscopic surgery, a surgeon makes three or four tiny incisions in the abdomen and inserts small instruments, including a flexible tube with a tiny camera, through the incisions. To provide more space for your surgeon to see and work, your abdomen is inflated with carbon dioxide. The surgery takes about two hours and typically requires an overnight hospital stay.
People who benefit most from a Nissen fundoplication are those who gained relief from medications. If you have minimal or no relief from medications, your doctor must be certain that you have GERD before recommending surgery, which may mean additional testing. Most people who undergo Nissen fundoplication remain free of GERD symptoms for at least one year. For the majority of people, this benefit extends beyond five years. This success rate applies to both the laparoscopic and open procedures.
Other surgical procedures include Toupet fundoplication, Hill repair and the Belsey Mark IV operation. All involve restructuring the lower esophageal sphincter to improve its strength and ability to prevent reflux. These surgeries are done less often, and their success is often dependent on the skill of the surgeon.
Complications from surgery generally are mild, but may include difficulty swallowing, bloating, diarrhea and a sense of feeling full after eating only a moderate amount (early satiety). These complications generally go away two to three months after surgery.
Newer, less-invasive procedures
Your doctor may suggest a procedure for tightening the lower esophageal sphincter. These procedures generally take an hour or less to perform, they don't require any incisions, and you can go home the same day. The procedures are performed endoscopically through a long, flexible tube that's inserted into your mouth and threaded through your esophagus. These procedures are recommended if you have a hiatal hernia or Barrett's esophagus.
* EndoCinch endoluminal gastroplication. This procedure uses a tool that's like a miniature sewing machine. It places pairs of stitches (sutures) in the stomach near the weakened sphincter. The suturing material is then tied together, creating barriers (plications) to prevent stomach acid from washing into your esophagus. The barriers are located at and just below the junction of the esophagus and stomach. The procedure may cause a sore throat or chest pain. The long-term effectiveness of the procedure is still unknown.
* Stretta procedure. This approach uses controlled radiofrequency energy to heat and melt (coagulate) tissues within the portion of the esophagus that contains the malfunctioning valve and at the junction of the esophagus and upper stomach. The procedure appears to work by creating scar tissue and altering the sensory nerves that respond to refluxed acid. The procedure may cause a sore throat or chest pain. The long-term effectiveness of the procedure is still unknown. I have taken many meds through the years and find that Protonix works the best for me. Sometimes it gets so bad that my doctor gives me a cocktail that instantly numbs all the way to my stomach and helps me.
Some foods affect GERD and should be avoided. Don't eat within 4 hours of bedtime. Sleep on several pillows or better yet the head of your bed elevated. I bought a sleep number bed and raise the head of my bed every night and it works wonders. STRESS is another bad cause of GERD. That's a hard one to avoid.
I have also found that when I have a bad attack that taking liquid Gaviscon helps. Also avoid taking meds without food. 1. Take Avipattikar powder or tablet with water on empty stomach for at least 3 to six months twice a day. It will correct your digestive track.
2. drink Noni herbal fruit juice if available in Muscat. I had similar problems much longer than you.
There was a lot of improvement when I consulted a Chinese Physician. One of your organs - usually the spleen is giving problems. What is GERD problem. |
