Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|cufflink13 - Tue Jun 19, 2007 9:58 pm||
I have had GERD for a number of years for which I was taking ranitidine until about 18 mos ago. At that time my reflux seemed to be getting worse so an endoscopy was done, showing mild irritation of lower espohogus and stomach. I was prescribed 20mg omeprazole 2x daily and have been on that ever since. However, certain foods like BBQ and those with vinegar, plus alcohol, still seem to bother me. Shouldn't I expect to be able to consume pretty much anything while on the PPI? If not, does that mean I should be on something else? Does reflux tend to worsen or PPIs become less effective with time or as I age? I'm 39 and don't smoke, 5'10" and 200 lbs. I get moderate exercise.
|Dr. A. Rajput - Wed Jun 20, 2007 1:02 pm||
PPIs aren't magic pills. They tend to slow down the pathology, not cure it. Every drug has its limitations.
To an extent yes. PPIs will do their job, but GERD 'could' worsen with age. Changing the lifestyle could help big time. PPIs still are the best bet when it comes to drugs in GERD.
This is how GERD is approached usually:-
Lifestyle: Weight loss, head-of-bed elevation, and avoidance of nocturnal meals and substances that ↓ lower esophageal spinter tone.
Health maintenance: Monitor for Barrett’s esophagus changes.
Pharmacologic: Started with antacids in patients with intermittent disease; ranitidine or PPIs in the ones with chronic and frequent problems.
Surgical: For refractory or severe disease, Nissen fundoplication may offer significant relief.
Hope this helps.
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