Treatment of Gastroesophageal Reflux Disease (GERD)

Treatment will depend on the symptoms and age of the patient. Your physician may recommend medication to reduce acid in the stomach in the early stages of GERD.

Medications include:

1. Antacids and H2-blockers -These are normally administered first and helps to reduce acid and prevent acid reflux. These are common choices for the treatment of children as the medications are in liquid form.

• cimetidine (Tagamet)

• ranitidine (Zantac)

• famotidine (Pepcid)

• nizatidine (Axid)

2. Proton-pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid.

• esomeprazole (Nexium)

• omeprazole (Prilosec)

• lansoprazole (Prevacid)

• rabeprazole (Aciphex)

• pantoprazole (Protonix)

3. Prokinetic Agents help control acid reflux. Prokinetics help strengthen the lower esophageal sphincter (LES) and cause the contents of the stomach to empty faster. This allows less time for acid reflux to occu

• metoclopramide (Reglan)

• cisapride (Propulsid)

• erythromycin (Dispertab, Robimycin)

• bethanechol (Duvoid, Urecholine)

 
There are reports of some severe side effects in children and adults from metoclopramide and cisapride. These side effects can include: confusion,diarrhea, and nausea. This type of medication can also have an undesirable reaction with other drugs; therefore is very important to inform your doctor of any other medications you/your child may be taking.

Apart from medication, there are other ways to reduce or avoid GERD: 

• Eat more frequently, but consume a smaller quantity per meal

• Avoid eating 2-3 hours before going to sleep

• Sleep with your head raised 6-8 inches (see diagram below)

• Try to avoid consuming carbonated drinks, chocolate, coffee, foods high in fats or acids, and fruit that is sour in taste

• If symptoms are not severe, it is recommended you exercise abdominal muscles which can help to improve the digestive process.

The last resort in dealing with GERD is surgical treatment. Surgery for GERD is known as anti-reflux surgery and involves a procedure called a fundoplication. The goal of a fundoplication is to reinforce the LES to recreate
the barrier that stops reflux from occurring. This is done by wrapping a portion of the stomach around the bottom of the esophagus in an effort to strengthen,augment, or recreate the LES valve.

Points to Remember

• GERD is caused by something in the stomach entering the esophagus.

• GERD is normal when it occurs in infants and children and will usually disappear when they grow up

• GERD may cause vomiting, cough, hoarseness, and pain while swallowing

• Treatment will depend on the symptoms and age of the patient. There are numerous treatment methods such as changing behavior, taking medication, and finally, surgery.