When your acid reflux symptoms are not being controlled by medication, it's time to see a gastroenterologist to discuss your options, specialists say.
(10) Despite the high efficacy of PPIs, up to 30% of patients continue to experience GERD-like symptoms even when adequately dosed. (7,8) Patients who do not respond to PPIs or have any alarm symptoms (e.g. dysphagia, odynophagia, weight loss, vomiting and/or abdominal pain) require further evaluation.
If you have reflux, medicine that reduces the stomach acid helps your body heal. It might take 1 to 3 weeks to heal. Follow-up care is a key part of your treatment and safety.
If GERD is left untreated, esophagitis can cause bleeding, ulcers, and chronic scarring. This scarring can narrow the esophagus, eventually interfering with your ability to swallow. One major complication which occurs in about 10% to 15% of people with chronic or longstanding GERD is Barrett's esophagus.
GERD can be a problem if it's not treated because, over time, the reflux of stomach acid damages the tissue lining the esophagus, causing inflammation and pain. In adults, long-lasting, untreated GERD can lead to permanent damage of the esophagus.
For some folks, it can last just a few minutes. Sometimes it can last for several hours. Heartburn happens about once a week for up to 20% of Americans and is common in pregnant women.
More serious complications may emerge, such as the precancerous condition known as Barrett's esophagus, as well as esophageal adenocarcinoma. These GERD complications can result in hospitalizations for anti-reflux surgery, such as Nissen fundoplication.
Seek immediate medical care if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack. Make an appointment with your doctor if you: Experience severe or frequent GERD symptoms.
Surgery for GERD may involve a procedure to reinforce the lower esophageal sphincter. The procedure is called Nissen fundoplication. In this procedure, the surgeon wraps the top of the stomach around the lower esophagus.
Some research suggests that inflammation in the esophagus (esophagitis) from gastroesophageal reflux disease (GERD) can take up to 8 weeks to heal with successful lifestyle changes and medications.
Surgery for GERD
The goal of surgery for reflux disease is to strengthen the anti-reflux barrier. During a procedure known as a Nissen fundoplication, your surgeon wraps the upper part of your stomach around the lower esophagus. This enhances the anti-reflux barrier and can provide permanent relief from reflux.
If your patient does not get relief from a PPI, all is not lost. If symptoms persist and PPIs are being taken correctly, use endoscopy and Bravo pH monitoring (if endoscopy is negative). An individualized approach incorporating newer technologies may offer relief.
Omeprazole is the fastest working PPI and reaches peak effectiveness in 30 minutes. Other PPIs—esomeprazole, lansoprazole, and dexlansoprazole—take 1-2 hours. Pantoprazole and rabeprazole take the longest.
Sometimes, if Gaviscon does not work or agree with you, your doctor or pharmacist may suggest another reflux suppressant. Like Gaviscon, you can buy Peptac or Acidex from pharmacies and supermarkets.
GERD and acid reflux cause a surprising number of hospitalizations and even some fatalities, mainly due to esophagitis, which is inflammation of the esophagus. Left untreated, esophagitis can lead to esophageal cancer.
Stage 3 (severe): A person has regular heartburn, a chronic cough, regurgitation, a hoarse voice, and regurgitation of food.
Your physician may suggest certain lifestyle changes, such as avoiding high-fat or spicy foods. Citrus fruits, mint flavorings, alcohol and coffee can aggravate GERD, too. These foods may irritate the esophagus or may make acid reflux more likely to occur by affecting the lower esophageal sphincter.
Nausea and GERD
Partnered with difficulty swallowing, coughing, and belching with GERD, many patients feel nauseated or experience vomiting. Indigestion has also been reported by some patients.
Heartburn-like pain is a common symptom of gastroesophageal reflux disease (GERD), but several other conditions can cause a burning feeling in your chest, including gallstones, stomach ulcer and esophageal cancer.
But doctors at NYU Langone may recommend surgery if GERD symptoms, such as heartburn, chest pain, and hoarseness, persist or if diagnostic tests show that GERD is caused by a hiatal hernia—a hole in the diaphragm that allows part of the stomach to enter the chest cavity.
Frequent/constant heartburn symptoms or heartburn everyday
If you have frequent or constant heartburn (more than twice a week or heartburn everyday), you may have gastroesophageal reflux disease (GERD).