Common Heartburn
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Hiatus Hernia |
Almost 18 million Americans suffer
from chronic heartburn - not the occasional heartburn that can be
treated with antacids - but the persistent heartburn that is
life-altering and, in fact may be a symptom of gastroesophageal reflux
disease (GERD). It interrupts their sleep, limits their activities,
keeps them from the foods they love; in short, it changes the way they
live their life. Many rely on over-the-counter or daily prescription
medications to help control it. And there's also an option called
videoscopic surgery that can let you live your life the way you used to,
without heartburn medication. Because videoscopic surgery doesn't just
treat the symptoms, it can fix
the problem.
Do You Have GERD?
Take this test, based on a test from the
American College of Gastroenterology, to see if you're a GERD sufferer
and are taking the right steps to treat it.
1) Do you
frequently have one or more of the following:
- An uncomfortable feeling behind the
breastbone that seems to be moving upward from the stomach?
- A burning sensation in the back of
your throat?
- A bitter acid taste in your mouth?
2) Do you often
experience these problems after meals?
3) Do you
experience heartburn or acid indigestion two or more times per week?
4) Do you find
that antacids only provide temporary relief from your symptoms?
5) Do you take
the maximum dosage of over-the-counter medication?
6) Are you
taking prescription medication to treat heartburn, and still having
symptoms?
7) Do you have
trouble swallowing or persistent abdominal pain?
If you said "yes"
to two or more of the above, you may have GERD. To
know for sure, see your doctor.
What is Videoscopic
Surgery?
Here's how it
works:
You may be familiar with the gallbladder procedure
called videoscopic or laparoscopic cholecystectomy, a less invasive
alternative to traditional or "open" surgery. A videoscopic
procedure is an alternative to open surgery in which small incisions are
made to accommodate small tubes called "trocars". The trocars
create a passageway for special surgical instruments and a laparoscope
-a fiber optic instrument used to examine and transmit images from
within the body to a video monitor allowing the surgeon to see the
operative area.
Open surgery vs.
Videoscopic surgery
Since the incisions are small (only about the size of
a dime), scarring tends to be greatly reduced. Patients who are
appropriate candidates for a videoscopic procedure usually experience
shorter hospital stays. Like gallbladders, most surgery for chronic
heartburn is done videoscopically. However, depending on patient
condition, a surgeon may recommend open surgery as the best alternative.
GERD Management
Approximately 100 million Americans
suffer from heartburn at least once a month. Of these, 17.5 million
suffer heartburn daily. Even worse, almost 1,750,000 people do not
respond to medical and/or pharmaceutical therapies. (Sources: Motor
Disorders of the Gastrointestinal Tract: What's new and what to do.
1993; Gallup Organization National Survey: Heartburn Across America.)
Statistics show that over-the-counter and
prescription drugs, combined with lifestyle changes, provide an
effective treatment plan for many patients presenting with
gastroesophageal reflux disease. However, not all patients respond to
these therapies because the underlying cause of the disease is
anatomical in nature
Is Videoscopic Surgery
for Chronic Heartburn Right for me?
Most patients are not candidates for
videoscopic surgery. However, videoscopic surgery is an option for
selected patients with severe chronic heartburn that still disrupts
their lives, despite lifestyle modifications and appropriate medication.
Other heartburn sufferers who may benefit from videoscopic surgery
include younger patients (50 years or younger) facing a lifetime of
medications, patients who find medications a financial burden, patients
who are noncompliant with their drug regimen, and patients who prefer a
single intervention to long-term therapy. Diagnostic testing is critical
for all patients to document the disease and determine whether surgery
is an appropriate option. **
Before surgery, a diagnostic evaluation
must be made to ensure that gastroesophageal reflux is the underlying
cause of the patient's symptoms. This is usually done with 24-hour
esophageal pH monitoring, endoscopy and/or a manometry test.
If you have tried over-the-counter or
prescription strength medication without relief, see your doctor or
gastroenterologist. Only your doctor can best determine whether you are
a candidate for a videoscopic surgical procedure to fix gastroesophageal
reflux or GERD. If he or she thinks you can benefit from the procedure,
you will then be referred to a surgeon. Your local medical center also
can help you find a surgeon skilled in the videoscopic procedure.
Questions to Ask Your
Doctor
The best way to understand your medical
options is to ask a professional. The questions below can help.
Questions to ask your
physician:
- Could surgery be the answer for me?
Why?
- What are my alternatives?
- Can you recommend a surgeon who
performs the videoscopic or laparoscopic procedure? I
- f surgery is for me, what are the next
steps?
If videoscopic or laparoscopic surgery is
right for you, your doctor may refer you to a surgeon who can better
address your concerns. These additional questions may help.
Questions to ask your
surgeon:
- Are you board-certified?
- How many times have you performed this
procedure?
- What have the outcomes been?
- What are the complications and/or side
effects?
- What should I do to prepare for the
surgery?
- What can I expect following
surgery?
- Can you give me the name of one of
your patients who has had the procedure so I can talk to him/her?
Options For Heartburn
Lifestyle
Modifications
Whether you have occasional or severe
chronic heartburn, the following basic lifestyle changes may help you
manage your heartburn and benefit your overall health.
- Don't lie down 2-3 hours after
eating.
- Raise the head of your bed
4-6".
- Maintain a healthy weight.
- Make time for physical activities,
like a walk around the block.
- Reduce stress by taking 15
minutes out of your day to relax or meditate.
- Don't smoke.
- Eat hard butterscotch or caramel
candies (not peppermint).
- Wear looser-fitting clothes and looser
belts around your waist.
- Avoid food and drinks that make
heartburn worse.
Can certain
medications make heartburn worse?
Certain medications can make heartburn
worse because they either promote acid production, relax the lower
esophageal sphincter (L.E.S.), or reduce saliva. Ask your pharmacist or
doctor if anything you're taking contributes to your heartburn, such as:
- Painkillers, like aspirin, ibuprofen
and naproxen
- Hormone progesterone (used in birth
control pills and postmenopausal therapy)
- Anticholinergics (prescribed for high
blood pressure)
- Tricyclic antidepressants (prescribed
for depression)
- Calcium channel blockers (prescribed
for high blood pressure)
- Theophyilline (prescribed for asthma)
Should I take
medication?
If you have frequent or severe heartburn
your doctor may prescribe a medication. Some (called over-the-counter
medications) are available at your local pharmacy and others (called
prescription medications) are available through your local doctor.
- Over-the-counter antacids, like
Mylanta®, neutralize stomach acid on contact and offer fast but
short-lived relief from heartburn symptoms.
- Over-the-counter H2-blockers, like
Pepcid AC®, last longer than antacids, suppress the amount of acid
in your stomach, and can be taken before meals to prevent
heartburn.
- Proton-pump inhibitors reduce the
amount of acid in the stomach, are very effective for persistent
cases of heartburn, and are available by prescription only.
- Also by prescription, prokinetics
speeds the movement of food through the digestive tract and
strengthens the lower esophageal sphincter (L.E.S.).
Remember, whether you're on medication or
not, lifestyle changes such as eating good foods, getting exercise, and
managing stress, are an important part of feeling better. Talk to your
doctor about choosing the best treatment plan.
