Watch this video to learn about the range of treatment available to provide relief for people who suffer with GERD (Gastroesophageal reflux disease)
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Steve Morris: Well, first of all, there is what we call the life style changes or life style modification. That’s really the basic building blocks upon which we build our other therapy. The first of these may if the patient is overweight to try and slim down and achieving more normal body weight. Second would be diet. We know that there are certain dietary factors that can predispose towards reflux, particularly let’s say, a high-fat diet affects the lower Esophageal Sphincter. Low is the pressure that’s the barrier between this esophagus and the stomach, allows more reflux so there can be dietary modifications. Not only the content of the diet but actually the timing of the intake. For example, we tell patients not to eat late at night before they go to sleep because the consequence of eating is the production of acidity. So if you eat late at night, you increase the amount of acid that your stomach produces and then this results of a lot of acid and volume in the stomach while you’re ready to lie down. Another thing is not lying down during the day after you’re eating. So those are some of the things we can do as far as diet and life-style modification. Stopping smoking, not drinking a lot of caffeine are also modifications that are beneficial. Once we get past the life style modifications, then we’re into what we term medical therapy. Robert Bresalier: There is a spectrum fortunately of medications that can treat reflux and you can really break them down into categories of drugs. The most simple thing is something that neutralizes acid; antacid is obviously have been around for long time and for somebody with the occasional symptoms who is awake, taking some antacids, maybe helpful symptomatically. Steve Morris: If the symptoms however are recurrent, they are not simply relived with the use of an antacid or you are having to use antacids quite frequently or f there are certainly any of what we term alarm symptoms, if these are associated with heart burns and weight loss, some difficulty swallowing, waking up frequently at night, any of these are alarm symptoms that we look for, and of course, a doctor should be consulted quite soon. Robert Bresalier: Then there are, what we call, H2 or Histamine-2 receptor antagonists. These block one of the receptors on the cell in the stomach that produces acid and they are good mild-to-moderate symptoms and reflux. Steve Morris: The treatment of ulcer disease was well-served by the H2 receptor blockers because it appears that the stimulation of acid by histamine was critical in the production of ulcers and then we also found an associated bacteria associated with ulcer is that we can now eradicate. However, in the product, in the treatment of reflux, it is much more difficult. It’s a more difficult problem, it’s a chronic problem and the elimination of acid has to be much more total than in the production -- than in the treatment of Ulcers. Robert Bresalier: The newest group of drugs; they’ve been around for over a decade in the United States are so called Proton Pump Inhibitors. Their importance is no matter what stimulates the acid secretion; they block the final pathway of acid secretion. That’s why they’re such good and potent drugs. These are very effective in treating all varieties of reflux disease. Steve Morris: What you look for in the treatment of Nighttime GERD is a medication that obviously lasts longer. For example, the drugs are mostly all given in the morning and what you want to do is trying block these proton pumps as they become active during the day and all of these medications are strived to last for a 24-hour period and the recommended dosage is one today in the morning. Robert Bresalier: I think that there are some newer proton pump inhibitors on the market which to some extent to cover a greater area of the night time period in terms of your ability to inhibit acid for different reasons and I think that there has been some evolution such as we’ve produced th
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