GERD Diagnosis and Treatment

How We Diagnose GERD

Frequent episodes of acid reflux could be a sign of GERD. Talk to your doctor about your symptoms. You might need a referral to see a Digestive Health Center gastroenterologist, a specialist in disorders of the stomach and intestines.

Here are some tests that help diagnose GERD:

  • Upper endoscopy: A camera attached to a flexible tube gives your doctor a close look at your esophagus. The device, called an endoscope, can also take a tissue sample, or biopsy, when necessary.
  • Esophageal manometry: The strength of your esophageal muscles is assessed by a flexible tube inserted into your esophagus.
  • Bravo esophageal pH test: A tiny capsule attached to the wall of your esophagus sends pH levels to a receiver on your belt.
  • Esophageal pH and impedance monitoring: This checks the acid levels in the esophagus under various conditions, such as while eating or sleeping.
  • Barium swallow: Barium sulfate, a metallic compound, shows up on X-rays so your doctor can inspect your esophagus and back of the mouth or throat (pharynx). You must first drink a barium solution.
  • Upper GI series: A more expansive exam using a barium solution and X-rays that cover the esophagus, stomach and small-intestine tract – the upper gastrointestinal, or GI, tract, that is.

How To Prepare For Your Diagnostic Test

Endoscopy



Over-the-Counter Drugs That Help Manage GERD

  • Antacids: Neutralize stomach acid. Ingredients can include aluminum, calcium, magnesium or sodium bicarbonate. Examples: Alka-Seltzer, Pepto-Bismol, Rolaids, Tums and Maalox.
  • H2 receptor blockers: Reduce the production of hydrochloric acid, a strong acid produced by the stomach to assist digestion. Examples: Pepcid AC, Tagamet and Zantac.
  • Proton pump inhibitor: Blocks the production of stomach acid. Examples: Nexium, Prilosec and Prevacid.

Diet and Lifestyle Changes to Control GERD

It’s important to identify the foods that trigger acid reflux. Record what you eat and when you experience symptoms. Share this journal with your doctor and a registered dietitian so they can help you manage symptoms through diet and lifestyle.

Consider avoiding these foods because they may trigger symptoms:

  • Foods that relax the lower esophageal sphincter such as chocolate, peppermint, caffeine and foods that are high in fat: fried foods, full fat milk and cheese, pastries and desserts.
  • Acidic and spicy foods that may irritate an injured esophagus: citrus fruit, tomatoes and tomato products, juice, carbonated beverages, chili peppers, black pepper, onions and garlic.

Lifestyle changes that help alleviate symptoms:

  • Have four or five small meals and avoid overeating.
  • Eat more fiber. In a study, GERD sufferers who followed a high-fiber meal plan were less likely to experience symptoms.
  • If you are overweight, losing those unwanted pounds can lessen your symptoms.
  • Wait at least two hours after a meal before exercising.
  • Don’t eat just before you go to bed. To alleviate nighttime symptoms, eat at least three to four hours before bedtime and raise the head of your bed six inches.

These foods might ease symptoms:

  • Low-fat dairy such as milk, yogurt, and kefir provide calcium, magnesium and potassium (alkaline minerals) that help balance stomach acid to ease symptoms quickly.
  • Fill half your plate with dark green vegetables such as broccoli, kale and spinach. These and other leafy greens are rich in symptom-fighting fiber and magnesium.
  • Oatmeal and other whole grains are also rich in fiber, which binds with stomach acid to reduce symptoms.
  • Ginger root is a natural remedy for heartburn and nausea. Researchers hypothesize that ginger’s effectiveness is due to its strong anti-inflammatory properties. Grate fresh ginger root into soups and smoothies and sip ginger tea one-half hour before, or after meals.
  • Select foods that are baked, broiled and steamed instead of fried, pan-fried or prepared in cream sauce.
  • Enjoy healthy fats that are also a good source of fiber, such as avocados, nuts and seeds.
  • Snack on low-acid fruit: melons, bananas, apples and pears.


Types of Procedures for GERD

When lifestyle changes and medications fail to control GERD, surgery becomes a possibility to repair or replace the lower esophageal sphincter – the valve that prevents the backflow of stomach acid.

Fundoplication

The most likely surgery choice, fundoplication, tightens or adds support to the sphincter by wrapping the upper part of the stomach around the lower esophagus.

Here are two types of fundoplication:

  • Nissen 360-degree wrap: The upper curve of the stomach, known as the fundus, is wrapped around the entire bottom of your esophagus.
  • Toupet 270-degree posterior wrap: The fundus is wrapped approximately two-thirds, or 270 degrees, around he back part of the bottom of your esophagus.

LINX

This relatively new procedure, approved by the Food and Drug Administration in 2012, is an alternative to fundoplication. Because it uses a laparoscope, a fiber-optic instrument requiring a small incision in the abdomen, recovery time is shorter. There’s also less pain associated with this surgery.

Using a laparoscope, your doctor implants the small LINX ring made of tiny magnetic titanium beads around the lower esophageal sphincter. This allows food to pass through it, but the ring otherwise keeps the opening between the stomach and esophagus closed, preventing backflow.


Make an Appointment

Call to schedule an appointment with a GI specialist at Hartford Hospital.
Ask your doctor for a referral before you call.

Call 833.431.0004

Digestive Health Center