Acid Reflux Treatment
The primary objective of acid reflux treatment is to suppress excessive stomach acid production and to correct dysfunction of the esophagus, the lower esophageal sphincter, or the stomach.
Because most cases of acid reflux are relatively mild, the first step to treatment for acid reflux is making lifestyle changes. In most cases that will mean changing what, when, and how much you eat. It may also mean quitting smoking or eliminating alcoholic beverages from your diet. Along with making the necessary alterations to your routine, you may want to try using over-the-counter medications such as antacids or acid reducers.
If your symptoms are moderate to severe and nothing else is working, you’ll probably need your doctor to prescribe you something stronger. There are two main drug treatment approaches taken for treating acid reflux: the step-up approach and the step-down approach. The step-up drug treatment approach involves giving the patient an over-the-counter H2 blocker medication that contains famotidine, cimetidine, nizatidine, and ranitidine. If the patients acid reflux symptoms don’t improve, his or her doctor will step up the treatment to include a potent prescription proton-pump inhibitor such as omeprazole, more commonly known by the brand name Prilosec.
In contrast, the step-down drug approach to treating acid reflux starts with the administration of a powerful medication like omeprazole. Once the patient has been without acid reflux symptoms for a period of two months or more, his or her dose of omeprazole is decreased by fifty percent. In some cases, if symptoms don’t come back, the doctor will take the patient off the drug altogether. But both the doctor and the patient will need to keep an eye out for a virtually inevitable future relapse of symptoms, since acid reflux is a chronic, or lie-long, condition. If the patient’s symptoms do reoccur after his or her dosage of omeprazole is cut in half, his or her doctor will recommend over-the-counter H2 blocker medications. Statistical studies have shown that 58% of patients who participate in the step-down treatment approach are symptom free for a year afterwards. 27% of those patients who underwent the step-down drug approach to treating acid were symptom free while using no medications—over the counter or prescription—at all. Unfortunately, no matter how successful a treatment method is, acid reflux symptoms usually do return.
When neither the step-down nor the step-up drug treatments work, it is the doctor’s responsibility to use diagnostic tests to look for another disease that may be causing your symptoms.
In extreme cases, the acid reflux patient may be required to undergo a surgical procedure called fundoplication surgery in order to experience some relief from acid reflux symptoms. Fundoplication surgery helps the acid reflux sufferer by strengthening the valve between the stomach and the esophagus. Esophageal surgery also improves regurgitation. Surgical treatments cannot cure acid reflux, they can only ease the condition and possibly eliminate the need to take high doses of strong medications continuously for extended periods of time. As with any surgical procedure, fundoplication surgery poses some risks. It’s up to the patient to weigh those risks against the prospective improvements to his or her quality of life.