Treatment options for GERD

You don't have to be brilliant to get ideas to write about. You simply focus on your own medical problems, and presto! - an endless supply of ideas, which brings me to a discussion of my GERD. But before you worry you're about to learn more about me than you really want to know, let me quickly tell you that GERD is simply the acronym for gastroesophageal disease, what happens when acid washes back from the stomach into the esophagus.

At least 20% of people regularly complain of GERD symptoms, mainly heartburn, acid indigestion, and food regurgitation, but including also wheezing, coughing, and chronic hoarseness from acid irritating the airways. For many, it's a daily problem, often worse at night. Factors that increase GERD include excess weight, lying down, bending at the waist, alcohol, smoking, and certain foods. Some culprit foods, such as chocolate (alas!) and onions, cause symptoms in all GERD sufferers, but others vary from person to person, so that I, for example, tolerate coffee easily (at least that's what I've convinced myself because otherwise I'd be forced to give up my 4 daily double cappuccinos), while other GERD sufferers literally can't stomach coffee. GERD also leads to a higher risk of esophageal cancer.

Treatment includes lifestyle modification (same old, same old), avoiding foods that cause problems (duhhh!), not lying down after eating, elevating the head of the bed, medications that either counteract acid (antacids) or antisecretory medications that stop acid from being produced (Zantac®, Pantoloc®, others), and for severe cases, surgery to tighten the sphincter between the esophagus and stomach.

The reason I bring GERD up today (a little acid humor, folks) is to address the growing number of GERD sufferers who figure that the surgery has improved so much (it's now often done as a "keyhole" procedure), that they'll undergo surgery so they can stop taking pills and go back to downing all the beer, chocolate, and hot sauce they like.

But according to a study in the Journal of the American Medical Association, 10 years after their surgery, nearly two thirds of GERD sufferers were again regularly using medication to control symptoms. Patients who chose surgery also had no lower risk of esophageal cancer than patients who stuck with medications, although happily, the overall rate of cancer was much lower than expected in both groups, that is, the rate of cancer in GERD patients may be lower than previously believed, which was very happy news for this long-time GERD sufferer and chronic worrier.

Also, in this study, people who chose surgery died at a faster rate than those who stuck with medications, a surprising finding for which there's no easy explanation, but one that reinforces the old dictum that you choose surgery - even simple "minor" surgery - only when all else fails.

As a prof once said to me when I pooh-poohed a worried patient's queries about an operation with the remark that, "Hey! Quit worrying. It's only minor surgery." - "The only minor surgery," my prof scoffed, "is surgery done on someone else."

The contents of this health site are for informational purposes only. Always seek the advice of your physician or other qualified healthcare provider regarding any questions you may have about a medical condition.

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