GERD Treatment

The exact cause of what weakens or relaxes the LES in GERD is not known, however certain factors including obesity, smoking, pregnancy, and possibly alcohol may contribute to GERD. Common foods that can worsen reflux symptoms include spicy foods, onions, chocolates, caffeine-containing drinks, mint flavorings, tomato-based foods and citrus fruits. Certain medications can also worsen the reflux.

Heartburn is usually the main symptom; a burning-type pain in the lower part of the mid-chest, behind the breast bone. Other symptoms such as a bitter or sour taste in the mouth, trouble in swallowing, nausea, dry cough or wheezing, regurgitation of food (bringing food back up into the mouth), hoarseness or change in voice, and chest pain may be experienced.

GERD is usually diagnosed based on a thorough medical history and physical exam. In most cases, a trial of writing a food diary, lifestyle modifications, and perhaps short-term medications will be done to see if symptoms improve before recommending further testing.

If needed, there are several tests that can be performed, and they include:

• Endoscopy: This test allows the doctor to examine the inside of the patient’s esophagus, stomach, and portions of the intestine, with an instrument called an endoscope, a thin flexible lighted tube.
• Barium X-rays: These are diagnostic x-rays in which barium is used to diagnose abnormalities of the digestive tract.
• pH monitoring: In this procedure, a tube will be inserted through the nose into the esophagus and positioned above the LES to record the pH of the acid content. Another option that may be used is a capsule that measures pH.

General measures the patient can take to reduce reflux are:

• Antacids or over-the-counter medicines that provide temporarily relief to heartburn or indigestion. Other medications such as proton pump inhibitors and H2 antagonists may be prescribed to reduce the production of acid in the stomach.
• Avoid eating 2-3 hours before going to bed
• Eat smaller and more frequent meals
• Lose weight if you are over weight
• Write a food diary to help eliminate the foods that increase the reflux
• Avoid smoking and use of alcohol

Osteopathic manipulative treatment (OMT) is a natural treatment modality that can be included in the management plan for improving symptoms of GERD.