Symptoms and Treatment Options for GERD, Part 2

Welcome back to today's health today, we're talking about GERD with surgeon Dr Zubin Bhesania

Doctor, to recap for our viewers What again are the symptoms of GERD? well most commonly people will talk about indigestion heartburn They may have trouble swallowing it They may feel foods getting stuck when they swallow they can have a Sore throat from reflux, and they can also have asthma

These are all very common problems with GERD Occasionally people will talk about when they sleep at night liquid and food are coming up And they wake up coughing now some of the symptoms of GERD sound a bit like other conditions How do you diagnose it sure so people will come and complain of indigestion not feeling well nausea Maybe some vague pain When people have heartburn and they describe burning or they describe reflux of food or liquid that's pretty easy to diagnose but sometimes These problems are mimicked by other diseases, so I'll have people come in saying I've got this pain that happens when I eat, and I think it's my gallbladder And we'll actually test for their gallbladder and nothing's there and we'll test for GERD We'll do a scope and we'll see it You know It's the other way around where people say I got heartburn And I'll do a scope and I'll take a look and it looks very good and so it makes you think of some Gallbladder issues and we have gall bladder dysfunction that can mimic GERD sometimes And we'll do some tests on that so basically The first step for people to have symptoms of GERD is we do a gastric scope to take a look at the problem If there is a problem sometimes will do manometry testing where we look at the esophagus to see how it's functioning The Esophagus is a muscular tube And it's supposed to push food down towards the stomach and sometimes people have dysfunction of the esophagus where it doesn't push food properly It can be too tight or it can be too loose and so the test for that Occasionally, we'll have people that have GERD symptoms And we don't really see much and so we'll do a 24-hour Ph probe where we'll actually measure acid within the esophagus so when they reflux we'll actually see the acid and have documentation that they are refluxing, so there's quite a few tests we can do to help document GERD And it sounds like there's a lot involved in ruling out other disorders and then there are a lot of testing procedures available for GERD? So sometimes it's simple to diagnose and sometimes it's a little more tricky, and you have to do the right test for it

Now once you do have a diagnosis of GERD what are the treatment options that are available? So typically people want to have the discomfort stop? So they'll start off with some medications And so the simple medications are things that will coat the stomach or decrease acid by neutralizing the acid so this Products such as tums or mylanta Will help coat the stomach or esophagus or decrease the acid by neutralizing the acid And now we have medications that we use and a very common one would be pepcid that's available over-the-counter and that works by decreasing The production of acid and then we have other drugs such as prilosec For example that are used to decrease acid, and it works on a different pathway than pepsin And then it also decreases acid and there are prescription strengths and over-the-counter strengths of these medications So how do the over-the-counter medications help and is that something that an individual should just go out and get on their own or at the recommendation of their doctor? Well typically people will take that if they have some discomfort, so they go to a party the next morning They've complained Harper And they'll reach for medication take the pain away If it becomes a more chronic problem typically their physicians will prescribe them a medication to take The problem is some of the medications have some long-term risks that we didn't know about ten years ago The most common drug class is the proton pump inhibitors, so a drunk like omeprazole prilosec And we now have new warnings with those that you need to be on them for a certain amount of time But they need to come off them to rescue and go back to normal so typically it's 12 weeks on And then four weeks off because it can decrease calcium, decrease magnesium Certain issues such as dementia or pneumonias can happen Women that are on them for long term have a higher risk of hip fractures So it sounds like there's some serious potential side effects from some of the prescription medications for GERD – Is there a time that you would decide between the over-the-counter and the risk is worth it for the prescription? Well I think if you're being prescribed as heartburn medications, you need to be careful with them and follow up with your physician to be checked and monitored

At some point people will decide that they don't want to take medications and want to fix the problem And that's why they'll get referred to a surgeon to have the problem looked at and see if it can be fixed Now other than over-the-counter and prescription medication, are their lifestyle modifications that can help to alleviate the symptoms of GERD? Sure, so people that don't want to have surgery or they don't want to take medications for the problem There are some simple things you can do You can elevate the head of your bed By putting some blocks underneath the head of the bed to elevate it to change the angle You can have weight loss so that decreases intra-abdominal pressure you can avoid eating or drinking late at night before you go to bed So you have a empty stomach so if it stomachs empty, you won't be able to reflux Doctor This is great information We need to take another break but will continue in a moment

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