LAPAROSOPIC SURGERY FOR GASTROESOPHAGEAL REFLUX DISEASE Gastroesophageal reflux is the most common gastrointestinal disorder of the western world. Gallup poles have elucidated that approximately 44 % of the adult population in the U.S. has some abnormal reflux of acidic gastric juices into the esophagus on a monthly basis. Roughly 10% of patients require daily acid suppression medication for relief of symptoms. GERD accounts for over 1.0 million out patient visits to physicians every year! Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly, and stomach contents splash back, or reflux, into the esophagus. The LES is a ring of muscle located at the far end of the esophagus as
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Antacids, however, have side effects. Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium carbonate antacids, such as TUMS, TITRALAC, and ALKA-2, can also be a supplemental source of calcium. These medications frequently cause constipation. In general antacids are good for occasional relief of symptoms in patients with mild disease. However for patients with more frequent symptoms and esophagitis, further therapy is usually required.
• Foaming agents, such as GAVISCON, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.
• H2 blockers, such as cimetidine (TAGAMET HB), famotidine (PEPCID AC), nizatidine (AXID AR), and ranitidine (ZANTAC 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have GERD symptoms. Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor. These medications act by significantly reducing the acid output of the stomach (60%-70%), and are very effective in relieving symptoms and healing esophagitis. However, some are better than