Treatments for GERD or Acid Reflux

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Dr Rajkumar JS

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Dr JS Rajkumar is the Chief Surgeon with LIMA.


There are so many treatments for GERD, it is easy to get confused and overwhelmed. Some of them are spurious, and some of them are counterproductive. It doesn’t help that symptoms of GERD are often confusing, leading to insufficient or erroneous treatments.

This section will help you to get a good grip of what treatment of GERD is most likely to work for you. Before you continue reading this section, make sure that you have read our page on GERD/Acid Reflux. That gives you the basic understanding of what goes wrong when you get this disease. That knowledge will be useful for you to evaluate the treatment options.

Lifestyle Modifications for Acid Reflux/GERD

Of course, most doctors wouldn’t agree that lifestyle modifications are listed mount treatments for GERD. But then again, if FDA can treat certain phone apps like drugs and insist on FDA approval, why can’t call lifestyle modifications as a treatment for GERD if they alleviate your symptoms!

The lifestyle modifications for GERD work on one or more of the following things:

  1. Reduce the production of acid in the stomach
  2. Increase the efficiency of the LES valve
  3. Reduce the opportunities for the food in the stomach from escaping back into the esophagus

For more details, go to our page on GERD and Lifestyle Modifications.

Diet Options for Acid Reflux/GERD

With acid reflux, diet is the first drug. With many patients, poor diet sets off acid reflux diseases through one or both of the following mechanisms:

  1. Dilating the LES valve
  2. Increasing the pressure in the stomach (increase fermentation of the food in the stomach, slow moving food, slow digesting food, over feeding, etc.)

If your disease is in its initial stage, you may be able to alleviate the symptoms simply by making some dietary changes. Here is our guideline for Indian diet for GERD/Acid Reflux. But use it with a word of caution: In severe cases of acid reflux, diet changes may not be adequate to eliminate future complications of GERD.

Nutritional Support for Acid Reflux/GERD

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Here are some nutrition that can help if you have GERD

  • Magnesium
  • Fiber in food reduces the chances of hiatus hernia
  • If there is occurrence of ulcer, taking cabbage juice regularly can help by healing it
  • If you have been taking antacids or PPIs for some time, you will benefit from dietary supplementation of hydrochloric acid
  • Dietary enzymes may help if your doctor thinks so

If you have acid reflux, or you have been on acid reflux medication for a long time, it can result in poor assimilation of nutrition like vitamins and minerals. Talk to your doctor to find out your nutritional status and get suitable supplementation to keep functioning at optimal level.

Exercise: Yoga for Acid Reflux/GERD

Many yoga proponents say that yoga is very effective in reducing the symptoms of acid reflux. Three groups of yoga seem to qualify as treatments for GERD:

  1. Yoga postures that involve bending backward are known to stretch the esophagus and alleviate the symptoms of acid reflux/GERD.
  2. Yoga exercise that control breathing strengthen the muscles in the diaphragm. Since the diaphragmatic muscles control the LES valve, the breathing exercises reduce the symptoms of acid reflux/GERD
  3. Calming exercises reduce the general stress level and thereby help with acid reflux/GERD

Like diet and lifestyle modifications, yoga may not be of much help in moderate or severe cases of acid reflux. Go to our page on Yoga for GERD/Acid Reflux to see a detailed list of yoga postures that will help your condition.

Other exercises can help acid reflux. But that is usually by helping the food in the stomach, if any, to digest and move away.

Medical Treatment for GERD/Acid Reflux

While the above might work on mild cases of GERD/Acid Reflux, more severe cases will most likely require medical intervention. The medical treatments for GERD usually work on one of the following two modalities:

  1. Reduce the secretion of acid in the stomach (PPIs like Omeprazole, Pantoprazole and Rabeprazole)
  2. Coat the inner lining of the esophagus to protect it from the stomach acid (antacids like Sucralfate and Gelusil)

Most gastroentrologists use these drugs as the first line of treatment. However, PPIs are a double edged sword. Unless you work with a knowledgeable doctor, the medication you take for acid reflux ends up reducing the stomach acid levels too much, thereby causing you new problems.

Go to our page on Medical Treatment for GERD/Acid Reflux for more details.

Physical Repair of LES Value

When you travel through the treatment ladder described above (lifestyle changes, diet modifications, exercises in the form of yoga stretches and medical treatment), large proportion of the patients seem to get better. However, there is a small group of patients in whom symptoms recur when the other treatments for GERD are stopped. These patients are best treated by physically strengthening their LES valve.

This treatment process, called fundoplication, involves

  • Tightening the diaphragmatic muscle that loops around the gullet so that diaphragm acts as a tighter pinch cock and shuts the LES valve down
  • Wrapping (plicating) the fundus of the stomach (upper part of the stomach) around the esophagus so as to decrease the radius of the sphincter, helping it shut tight more efficiently
  • Increasing the length of esophagus inside the abdomen so that there is more pressure on it, which shuts it tighter

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With experienced surgeons at LIMA, this procedure takes about 20 to 30 minutes to complete under general anesthesia. The patient usually gets back home at the same or a day after. In this procedure, no part of your body is removed. The procedure benefits you by making a weaker part of the body as strong as it must be. Thereby, it fixes the acid reflux problem once and far all.

Go to our page on fundoplication to learn more.

Alternative Interventions for Acid Reflux/GERD

There are some newer endoscopic techniques for tightening the valve, like creating multiple burns using a radio frequency probe. Or endoscopically taking one or two stiches in that area. There is also the latest procedure with using a magnetic ring as an elastic rubber band around the LES valve. However, these are all inferior in effectiveness and safety when compared to the laparoscopic fundoplication, which remains the gold standard of therapy for GERD.


GERD/LPR Expertise at LIMA

  • Our Chief Surgeon Dr. J. S. Rajkumar had authored a text book titled Modern Methods for Managing Acid Reflux/GERD. All the knowledge he used in writing this textbook are now incorporated in LIMA’s practice.
  • LIMA has all the instrumentation needed to accurately investigate and assess how mild or severe your acid reflux is
  • LIMA consultants offers the full range of Acid Reflux/GERD treatment, including
    • Behavior modification experts to help you with lifestyle changes
    • Registered dieticians to help you with a suitable diet selection
    • Functional medicine doctors to help you with nutritional support
    • Gastroenterologists to help you with medical protocol
    • The surgical group that has handled more volume than anyone else in South India

If the nature of your GERD is such that it doesn’t respond satisfactorily for lifestyle, dietary or medical interventions, then a surgical solution is your best option. If you select surgery, LIMA can give you “unparalleled advantage”:

  • Till date, we have carried out more than 2,000+ fundoplication surgeries. This is the largest volume handled by any single surgical team in South India.
  • LIMA is the only center in the Chennai where you can get the surgery done through a Scarless procedure.
  • LIMA subsidiary, MISTY, has trained largest number of surgeons in the country for
  • Currently, Dr. J. S. Rajkumar is co-authoring the first and only manual for laparoscopic surgery (14 volumes)

Testimonials

Listen to some of our real patients who received acid reflux/GERD treatment at LIMA:

Testimonial Videos

Even more Education

If you have read this far, we must congratulate you. You have taken your first step towards becoming an intelligent and informed patient. Very few patients have so much of dedication or put in the necessary efforts to empower themselves with the right kind of knowledge. Here are a few things you can do to further your knowledge:

  • Enroll yourself in our free newsletter about Acid Reflux/GERD management
  • Download our free ebook on Acid Reflux/GERD
  • Download our free ebook on Indian diets for GERD
  • LIKE our Facebook page on Acid Reflux/GERD to receive daily updates on this disease
  • LIKE our LIMA Facebook page to updates on other cutting edge treatments available only at LIM

Meet a Doctor

Do you think you have some of the symptoms described here. Fix an appointment with a LIMA doctor and get a thorough investigation. Unlike other chronic diseases, GERD can be easily treated if you catch it before it turns malignant.


Free eBook on GERD

Do you or someone you love has GERD (Acid Reflux). Download our free eBook specially prepared for the Indian patient, written by highly accomplished Indian surgeons, who have published several books for the international audience.


Knowledge base discussions

Go to the GERD/Acid Reflux page on our forum. Questions that patients like you asked and answers they received from LIMA or from other patients are permanently here, just frozen in time, waiting for you to benefit from the collective wisdom.