Acid Reflux Treatment

Surgical treatments are usually effective in controlling severe gastroesophageal reflux. The fundoplication was found to be more effective than ranitidine + metoclorpropamida in a study with 2 years of follow-up. The surgery for gastroesophageal reflux disease is indicated for patients who do not respond to tto. medical (H-2 blocker) with complications due to reflux or will not take the medication (inhibitors of proton pump), or who can not stop tto. medical (inhibitors of proton pump, H-2 blockers) without recurrence of symptoms. Tto costs. long term, the uncertainty of the consequences of tto. inhibitors with chronic proton pump, are also indications for surgery. Surgical treatment may be using the techniques reliza Hill, Belsey Nissen or Toupet. Fundoplication can be performed through open surgery or laparoscopy.

The surgery is best known Nissen fundoplication or modifications of this technique. The technique includes the mobilization and fondus fundoplication of the stomach around the ISS. As the pressure increases in the stomach, creating a pressure aumneto fundolicatura in closing the EEI, preventing reflux. The procedure is performed after the placement of a candle in the esophagus as a measure to prevent a too tight fundoplication. Fundoplication can be performed through open surgery or laparoscopy. The advantage of open surgery include the possibility palpation. Laparoscopy allows a clear view of the anatomical structure exist, less pain and faster recovery.

Patients with a history gastrooesofagico typical reflux should be managed initially with health and diet changes. They should avoid foods and beverages that could decrease the LES tone. These include chocolate, peppermint, fatty foods, coffee and alcoholic beverages. Foods or beverages that may irritate or inflame the esophageal mucosa, such as citrus, tomato products and pepper, should be avoided. The elevation of the head while sleeping, not lying down after meals and not smoking are measures that help prevent reflux.

The tto. doctor is directed to reduce the acidity of the refluxed material using H-2 blockers, or inhibitors of the proton pump. The success of tto. be related to the ability to cause increased inhibition of acid. In theory, drugs that promote esophageal motility (including cisapride, metoclorpropamida, domperidone) improve esophageal evacuation, decrease LES tone and improve gastric emptying, but in practice are of little benefit for these patients.

Although tto. physician is very effective in controlling the signs and symptoms of gastroesophageal reflux, aproximadanmente 80% of patients will have recurrence of symptoms within 3 months if therapy is discontinued. Either way the total control of symptoms can be achieved Medinat the tto. inhibitors continuous proton pump.