Minimally Invasive Surgery
About Achalasia
Reflux After Treatment
The approach to the treatment of gastroesophageal reflux disease has 7 basic principles:
- Reduce intra-abdominal pressure: don't wear tight clothing, don't eat immediately before going to bed, avoid lifting, and eat small meals.
- Assist gravity: elevate the head of your bed at night and avoid bending over.
- Increase the lower esophageal pressure, e.g., avoid coffee, tea or cola which, through their caffeine content, decrease pressure. Alcohol, cigarettes or nicotine of any type, also decrease pressure. Drugs such as nitrates, theophylline and calcium channel blockers will also decrease pressure. Drugs that may increase the lower esophageal pressure directly, such as Propulsid (cisapride) and Reglan (metoclopramide), may be prescribed.
- Avoid fatty foods, which delay the emptying of the stomach.
- Use drugs that decrease acid production. H2 blockers include Axid (nizatidine), Tagamet (cimetidine), Pepcid (famotidine), and Zantac (ranitidine), as well as the proton pump inhibitors Prilosec (omeprazole) and Prevacid (lansoprazole).
- Avoid foods that increase acid production or have a lot of acid. For example, caffeine, alcohol, peppermint and nicotine all stimulate the production of acid. Citrus fruits, onions and tomatoes all contain significant amounts of acid. Spicy foods also should be avoided because they will burn even though they may not contain acid.
- Avoid situations that increase acid production by the stomach, i.e., stress.
Anti-reflux surgery is considered for patients for whom these measures fail
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