A wide variety of special circumstances can influence a treatment plan for acid reflux and gastroesophageal reflux disease (GERD). One special case is acid reflux caused by a hiatal hernia (a condition in which a small section of the stomach gets pushed up into a hole in the diaphragm).
Smaller hernias probably won’t cause many noticeable symptoms; however, a larger hernia can cause food and stomach acid to get trapped in the esophagus, causing severe reflux and discomfort.
In most cases, doctors may have to do some procedures (such as an upper endoscopy, esophageal pH test, or esophageal manometry) to verify if the hiatal hernia is the cause of the reflux. When your doctor has determined the cause, he’ll map out a treatment plan.
There are a variety of treatments for hiatal hernias depending on the specifics of your condition. In some cases, the doctor may prescribe over-the-counter antacids or even prescription acid reflux medication. Treatment will also usually require you to adjust eating and sleeping schedules.
It’ll be important for you to eat several small meals a day — try to minimize the amount of food you eat at any one time. This will help reduce the likelihood that your reflux or GERD will flare up. You’ll also want to avoid lying down for at least three hours after eating or drinking.
In some cases, your doctor will recommend surgery to correct the problem. It’s usually a laparoscopic procedure with a recovery time between five and ten days.
Treating your reflux or GERD while combating an ulcer is another special situation. For patients with both reflux and ulcers, the pain can be excruciating. Reflux symptoms tend to manifest in the upper chest, but ulcer pain usually falls between the sternum and navel. If you have a bad case of both, you could experience pain and discomfort in your whole chest and abdomen.
If your doctor determines that your ulcer has been caused by a bacteria living in the mucous coating your stomach (Helicobacter pylori), he’ll treat the bacteria with strong antacid medications and antibiotics for 7 to 14 days.
Successful treatment of H. pylori usually means that the recovered stomach lining then secretes even more acid, making your reflux symptoms worse, at least temporarily. After the H. pylori has been cleared, you may need lifelong antacid medication to manage the reflux.
Even generally innocuous over-the-counter medications like aspirin have been known to cause reflux flare-ups. Other medications that have been routinely linked to reflux and GERD include, antibiotics, steroids, antihistamines, heart medications, osteoporosis medications, chemotherapy drugs, pain medications, and even potassium and iron supplements.
Talk openly with your doctor and pharmacist about your reflux symptoms. It’s a good idea to get all your medications through the same pharmacist so she can check for any drug interactions. The pharmacist may also be able to find a comparable medication that won’t impact your reflux. And don’t be afraid to try some of the usual remedies for reflux, such as a nice ginger tea or other stomach soothers.