Approximately 20 percent of adults in the United States have gastroesophageal reflux disease, according to Kenneth McQuaid, M.D., Chief of the Gastroenterology Section at San Francisco V.A. Medical Center in "Current Medical Diagnosis & Treatment." They have heartburn at least once every week and as many as 10 percent have heartburn every day. Most people have a mild case of reflux, but some do experience more serious symptoms. There are several remedies available.
Lifestyle Changes
There are several lifestyle changes that are recommended as remedies for reflux. In fact, John Saltzman, M.D., Associate Professor of Medicine at Harvard Medical School writes in "Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy" that lifestyle changes are the cornerstone for treating reflux. People should eat smaller meals and eat more frequently. They should stop eating foods that can cause reflux or make it worse such as chocolate, carbonated beverages, peppermint, alcohol and fatty foods. It is recommended that people stop eating acidic foods like tomatoes, vinegar, citrus fruits and spicy food. They should stop smoking cigarettes and drinking coffee. People with reflux should not lie down within three hours after eating, and should raise the heads of the beds by six inches. And if they are overweight, they should lose weight.
Antacids
Dr. Saltzman explains in "Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy" that antacids are a remedy for reflux because they neutralize the stomach acid that is refluxing into the esophagus. They are effective. Using antacids occasionally for a little while is considered to be safe.
H2-Receptor Antagonist
A receptor is a protein molecule within a cell, or on the cell membrane. It receives signals telling it what to do. The H2 receptor is the histamine 2 receptor. These receptors are on the cells in the stomach called the parietal cells. When they are stimulated, they release gastric acid. Ranitidine, famotidine, cimetidine and nizatidine are a class of drugs known as H2-receptor antagonists. They antagonize or block the H2 receptors. In blocking the receptors, they are competing with the histamine. Thus, histamine cannot attach to the receptor on the parietal cells and stimulate them to release gastric acid.
Proton Pump Inhibitors
The parietal cells of the stomach have proton pumps. The term proton refers to hydrogen ions, which are acidic. The proton pumps secrete, or pump, hydrogen ions, according to Sidney Cohen, M.D., Professor of Medicine at Thomas Jefferson University Hospital in "The Merck Manual." Proton pump inhibitors will inhibit or stop the proton pumps from secreting hydrogen ions. Omeprazole, esomeprazole, rabeprazole, pantoprazole and lansoprazole are proton pump inhibitors used as remedies for gastroesophageal reflux.
Nissen Fundoplication
A surgical remedy for gastroesophageal reflux prevents reflux because the esophagus is made narrower at the section near the stomach. But it must also allow room for people to belch, swallow and even vomit when necessary, according to Blair Jobe, M.D., Associate Professor of Surgery at the University of Pittsburgh in "Schwartz's Principles of Surgery." The most common surgical procedure done is called a Nissen fundoplication. The fundus is the upper section of the stomach. Once food passes through the esophagus, it will enter the fundus. A fundoplication is an operation whereby the fundus is wrapped around the lower part of the esophagus, the part nearest the stomach. Dr. Rudolph Nissen was the first surgeon to perform this operation.
References
- "Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy"; Norton Greenberger, M.D.; 2009
- "Current Medical Diagnosis & Treatment 2010"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2010
- "Schwartz's Principles of Surgery"; F. Charles Brunicardi, M.D.; 2010
- The Merck Manual for Healthcare Professionals: Drug Treatment of Gastric Acidity
