Hearing you have gastro-oesophageal reflux disease (GORD) may be scary. However, it’s often well-managed with lifestyle modifications and medications. Our page discusses the treatment options for GORD in the order you can typically expect to receive this treatment.
GORD treatment
Below we list the usual treating order for this condition:
- Lifestyle modifications
- Medications, alongside lifestyle changes
- Minimally-invasive endoscopic procedures
- Surgical options
Lifestyle modifications and medications
Many people manage this condition with lifestyle modifications and over-the-counter medications. Your doctor can prescribe medications if these don’t work. Read our blog to learn more about lifestyle changes that can help relieve your symptoms: Living with GORD.
Antacids
Known as a quick relief for reflux, antacids neutralise acid and reduce the stomach’s acidity levels. You can get them in liquid, chewable, and dissolvable tablet forms. It’s rare to experience side effects due to antacids, but you may feel or be sick if you take too much.
Your doctor may recommend these alongside lifestyle changes or other medications, but you can get them from your local pharmacy without a prescription. Speak to your doctor if your symptoms don’t improve after two to three weeks.
Proton pump inhibitors (PPIs)
Proton pumps in your stomach produce acid. PPIs work to prevent these pumps from releasing too much acid. Side effects of PPIs include headaches, diarrhoea, constipation, dizziness, and abdominal pain, though these side effects tend to be mild.
Some people with GORD get erosive oesophagitis. Oesophagitis refers to an inflamed oesophagus. If you have erosive oesophagitis, stomach acid has damaged your oesophageal lining, which can take six to nine months to heal fully. PPIs may be most effective for people with erosive oesophagitis as they allow the oesophagus time to heal.
We usually start with a low dose and increase it as necessary. We may prescribe additional medications if you still experience reflux after increasing your dosage, such as H2 blockers.
H2 blockers
Like PPIs, H2 blockers can lower how much acid your stomach produces. We may recommend them alongside or instead of PPIs. It’s uncommon to experience side effects with H2 blockers, but you may feel tired or dizzy. You might also get a rash, headaches or diarrhoea.
In general, PPIs are better at reducing stomach acid than H2 blockers. However, H2 blockers are a good option if you react strongly to PPIs. How long you take them will depend on your circumstances. It may be as you need them or every day for a short or long time. Our gastroenterologist will let you know what they think will work best for you.
Endoscopic procedures
Stretta therapy
Many people with GORD have a weak lower oesophageal sphincter (LOS), meaning it’s easier for acid to reflux up the oesophagus. Stretta aims to strengthen the LOS using radiofrequency energy.
We use an endoscope (small, flexible tube with a light and camera at the end) during Stretta therapy to reach your LOS. Then we can use the radiofrequency energy to apply heat to the LOS, thickening the muscles so they can function better. The procedure takes around 40 minutes to an hour.
Stretta has a high success rate, though it may be between two months to a year before your reflux reduces. As it is a minimally-invasive procedure, you’ll have a quick recovery. This procedure also has a low risk of complications.
Transoral incisionless fundoplication (TIF)
Another way we can support the LOS is by wrapping some of your upper stomach around the area. We do this with a TIF procedure. Compared to the laparoscopic option (detailed below), TIF is less invasive, meaning a faster recovery time. However, you may not be suitable if you have a large hiatal hernia.
During TIF, we correct or recreate the barrier between your stomach and your oesophagus. We insert a TIF device using an endoscope to do this. Then we use polypropylene fasteners to hold your new partial wrap in place.
After the procedure, you may have a sore throat and minor chest pain for a few days as you recover. In four to six weeks, you may be able to stop taking PPIs and have a better quality of life.
Surgical options
Nissen fundoplication
Like the TIF procedure, Nissen fundoplication involves wrapping your upper stomach around your lower oesophagus to reinforce the LOS. We call this part of the stomach the gastric fundus. In TIF, we perform a partial wrap (usually 270°), but we do a full wrap (360°) during this procedure. We use sutures (stitches) to secure this in place.
There are two types of Nissen fundoplication: laparoscopic and open surgery. Laparoscopic (keyhole) surgery is less invasive. We insert our surgical tools for this procedure through small cuts. Open surgery requires one large cut. These types are equally effective at controlling reflux, but we prefer the laparoscopic approach. Its less invasive approach means a faster recovery time and a lower risk of complications.
Nissen fundoplication takes around 3 hours, not including the recovery time from the anaesthesia. As with TIF, your throat may feel sore for a few days after the procedure, and you may have some temporary trouble swallowing. You will need to adopt a liquid diet for the first day after and a soft food diet for at least two weeks. You’ll also need to eat smaller meals than usual. Our gastroenterologist will discuss for exactly how long with you, depending on your circumstances.
Laparoscopic insertion of a magnetic bead band (LINX)
The LINX device assists your LOS in doing its job. It consists of a ring of magnetic titanium beads that we place around your lower oesophagus. Its magnetic attraction applies pressure to the LOS, causing it to remain closed to reflux. However, the process of swallowing is strong enough to open it. Once the food or liquid has passed, the beads re-close the LOS.
This procedure takes an hour to complete, and we perform it laparoscopically. With LINX, you should have no problem vomiting or belching, which can be a side effect of other surgical procedures for GORD, including fundoplication. Like the above procedures, you may have some difficulty swallowing for a short time. Most people can resume their usual diet after the surgery, as we do not surgically alter the stomach.
Private GORD treatment at Digestive Health UK
Treatment options for GORD vary depending on the severity of your condition and previously tried treatments. Other factors, such as whether you have a hiatal hernia or are pregnant, will influence your treatment plan.
At Digestive Health UK, our specialists perform thorough diagnostic tests to determine how severe your condition is and how it’s affecting your body. Before we go ahead with any treatment, we will discuss its possible side effects and why we’re recommending it to you.
We want you to be in control of your health, making informed decisions about your care. Feel free to ask any question to help you get the treatment you need and prefer.
Prioritise your digestive health today and book an appointment with our world-renowned specialists.
