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Gastrointestinal Disorders

​Treatment of Upper ​GI Disorders

GERD (Gastroesophageal Reflux Disease and hiatal hernia with symptoms)

Daily proton pump inhibitor (PPI) therapy (Aciphex, Nexium, Prilosec, Prevacid, or other similar drugs). In some other cases a nighttime H2 blocker (Tagamet, Pepcid, Zantac and other drugs may be prescribed as well. In some cases laparoscopic surgery (Nissen fundoplication) can be considered if non-responsive to primary treatment measures. Dietary and postural measures are important as well.

Barrett’s Esophagus

Regular endoscopies with biopsy, especially in high-risk patients; regular use of medications to control the acid reflux (H2 blockers, PPI’s, antacids); non-steroidal anti-inflammatory drugs, endoscopic mucosal resection, or surgery. Esophageal Strictures: open up stricture by dilating it with either a weighted tube called a bougie or a balloon, and treat as for GERD with proton pump inhibitor antacids.

Disorders of Esophageal Motility, Achalasia and Diffuse Esophageal Spasm

Regular endoscopies with biopsy, especially in high-risk patients; regular use of medications to control the acid reflux (H2 blockers, PPI’s, antacids); non-steroidal anti-inflammatory drugs, endoscopic mucosal resection, or surgery. Esophageal Strictures: open up stricture by dilating it with either a weighted tube called a bougie or a balloon, and treat as for GERD with proton pump inhibitor antacids.

Refractory Heartburn

Diet and beverages selected are important and are discussed under Link 5. Short term antacids like Maalox, Rolaids, Gaviscon and Tums may work if only used occasionally. They can cause health problems if used daily. H2 blockers may be helpful. If symptoms continue, proton pump inhibitor therapy may be indicated.

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