Deteriorating GERD despite medication: Crucial insights provided
In the battle against Gastroesophageal Reflux Disease (GERD), understanding the complexities of the condition is essential. While medications and lifestyle changes can offer relief for many, persistent symptoms may require a more holistic approach.
If new or worsening symptoms develop, a person may wish to contact a doctor. Antacids are recommended for mild, intermittent GERD and provide short-term relief as needed. However, if symptoms do not ease following the use of medications and lifestyle changes, a doctor can help determine why a person's symptoms persist and suggest any changes to their treatment plan.
The lower esophageal sphincter (LES) plays a crucial role in GERD management. If the LES function is not improving completely, acid reflux can still occur despite medication aimed at reducing stomach acid or improving sphincter tone. Other factors contributing to persistent symptoms include hiatal hernia or anatomical issues, lifestyle and dietary factors, medications that relax the LES, sleep disturbances, psychological factors, gut microbiome imbalance, severity and disease progression, and other underlying conditions that mimic GERD.
Lifestyle changes can significantly impact GERD management. Eating meals at least 3 hours before bedtime, avoiding food or drinks that worsen symptoms, and getting enough quality sleep are all recommended. Medical professionals will often recommend weight management as a part of GERD management, as obesity is a risk factor for GERD. A person may also want to avoid lying down for at least 3 hours after eating a meal.
Fast-acting PPIs should be taken about an hour before a meal for effective management of symptoms that occur after eating. H2RAs can start working within 30 minutes to an hour and provide relief for 4-10 hours. The PPI omeprazole can take 1-4 days to start reducing heartburn symptoms.
Several underlying conditions can cause symptoms similar to those of GERD, including eosinophilic esophagitis, esophageal webs and rings, scleroderma, esophageal cancer, motility disorders, Crohn's disease, certain infections such as fungal and herpes simplex virus. Some foods and drinks may raise the risk of GERD, including high-fat foods, spicy foods, chocolate, citrus fruits, tomato-based foods, garlic, onions, mint, caffeine, carbonated drinks, and alcohol.
If symptoms do not ease despite lifestyle changes and medications, a person may consider contacting a doctor. A doctor can help ensure that a person is taking their medication correctly and may order tests to rule out other possible causes. By taking a comprehensive approach that addresses all contributing factors, persistent GERD symptoms can be effectively managed.
