Treatment Options

The treatment and management of GERD or heartburn includes lifestyle changes, medications and in more severe cases, surgery.  While medications may relieve the symptoms of GERD, they do not correct or stop the reflux completely.  The side effects from medications and the life-long commitment to taking them may be unwanted and overwhelming.  For patients looking for a more permanent solution, surgery may be necessary.

Lifestyle Changes

Lifestyle Changes that can help you control your GERD symptoms:

  • Quit smoking
  • Maintain a healthy weight
  • Limit alcohol
  • Avoid eating 3 hours before lying down
  • Raise the head of your bed
  • Avoid foods that can make symptoms worse (spicy foods, fatty foods, mint, chocolate, tomato-based foods, coffee, and citrus fruits)

Medicines

Medicines can also play a significant role in controlling reflux.  For many people, over the counter (OTC) medications that neutralize stomach acid are sufficient to provide temporary relief from intermittent GERD symptoms.  The most common type of these medications, proton pump inhibitors (PPIs) can completely prevent the production of stomach acid.  With little or no acid, many patients do not feel the symptomatic and uncomfortable burning sensation associated with reflux.  PPI’s are generally FDA approved for 8 weeks use.  While safe and effective for most patients, PPI’s are not recommended for long-term use (greater than one year).  If you are concerned about long-term effects of PPI usage, be sure to consult your physician.

Surgery

Antireflux Surgery may be appropriate for some patients who are:

  • Dissatisfied with pharmaceutical therapies and the lifestyle changes required to treat symptoms
  • Suffering from non-acid symptoms of reflux such as asthma, persistent cough or sore throat
  • Dissatisfied with progressively increasing dosages of reflux medications

Surgery for GERD is called “fundoplication”.  These procedures have been successfully performed for over 50 years.  The procedure involves reconstructing the valve between the esophagus and the stomach to prevent reflux.  If a hiatal hernia is present it may also be repaired at the same time.
 
Surgical Options Available at Kona Community Hospital Include:

Incisionless Surgery – Transoral Incisionless Fundoplication (TIF) 

  • Performed through the mouth with no abdominal incisions
  • An option for patients who do not have large hiatal hernias
  • Patients typically return to work in less than a week

Laparoscopic Surgery – Fundoplication

  • Performed through 3-5 small incisions in the abdomen
  • Can be performed on patients with any size hiatal hernia
  • Patients typically return to work in 1-2 weeks

Questionnaire and Understanding Risk