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Antacids

neutralize acid

H2 Blockers Over-the- counter

mildly suppress acid

Promotility

increase LES pressure; move acid from esophagus and stomach

H2 Blockers Prescription

moderately suppress acid

H2 Blockers +Promotility

moderately suppress acid; move acid from esophagus and stomach

High Dose H2 Blockers

moderately suppress acid

Proton Pump Inhibitors

markedly suppress acid

Surgery

improve barrier between stomach and esophagus to prevent acid reflux

+3

+3

+2

+2

Heal Esophagitis

Manage or Prevent Complications

Maintain Remission

0

0

0

0

0

0

+1

0

+1

+2

+2

+1

+1

+3

+3

+1

+1

+4

+4

+3

+4

+4

+4

+3

+4

Class of

How It

Eliminate

Drugs

Works

Symptoms

Effectiveness of Therapies for GERD

+1

+1

+2

Rating Scale: 0 (no effect) to +4 (nearly 100%) From An Update on GERD Educational Slide Lecture program, ©1996 ACG.

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the esophagus), which is progressive. The surgical technique improves the natural barrier between the stomach and the esophagus that prevents acid reflux from occurring. Consultation with both a gastroenterologist and a surgeon is recommended prior to such a decision.

There are always new treatments and possibilities looming on the horizon. There are two new endoscopic techniques for treating GERD — suturing and the Stretta radio frequency technique

  • which have recently been approved by the FDA

for use with patients. Because these treatments are so new, we do not have any real information concerning their long-term effectiveness. They were approved by the FDA largely based on data showing that they could help reduce GERD for at least six months after treatment. At least in the foreseeable future, until long-term outcomes can be evaluated, most patients and physicians will likely be sticking with the treatment options about which there is a much greater wealth of experience, e.g. medical treatment with proton pump inhibitors and other acid suppression medications, and surgery.

What is a Gastroenterologist?

A gastroenterologist is a physician who specializes in disorders and conditions of the gastrointestinal tract. Most gastroenterologists are board-certified in this subspecialty. After completing the same training as all other physicians, they first complete at least two years of additional training in order to attain board certification in internal medicine, then gastroenterologists study for an additional 2-3 years to train specifically in conditions of the gastrointestinal tract.

What type of tests are needed to evaluate GERD?

Your doctor or gastroenterologist may wish to evaluate your symptoms with additional tests when it is unclear whether your symptoms are caused by

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