House Calls

SPR 2018

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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h o u s e c a l l s { spring 2018 } 37 says Dr. Lucas, who adds that esophagitis increases a person's risk for esophageal cancer. Regardless of severity, lifestyle changes can help curb acid reflux or GERD symptoms. "Eat smaller portions, chew food slowly, and avoid any foods that seem to trigger reflux," advises Dr. Lucas (see sidebar to the right for common triggers). You can also help gravity keep stomach acids where they belong by remaining upright for at least three hours after you eat and elevating your head and torso during sleep. Consider investing in a bed that raises and reclines, use pillows to prop up your upper body, or place blocks under the top two bedposts, Dr. Lucas suggests. Over the long-term, those who are overweight should focus on reaching a healthy BMI. "Losing excess weight can significantly improve symptoms," says Dr. Lucas. And because smoking relaxes the LES, kicking that habit is important, as well. As for medication, a variety of drugs are available for immediate relief, from antacids to proton pump inhibitors, or PPIs (see sidebar for details). However, you shouldn't treat yourself with OTC meds for more than two weeks without consulting a doctor. "All can cause side effects, and we have data to suggest that long-term use of PPIs could cause problems with renal function and calcium metabolism, which can lead to hip, wrist, and spinal fractures," says Dr. Lucas. • Spicy foods • Onions • Citrus fruits and citrus products • Tomatoes and tomato products, such as ketchup • Fatty or fried foods • Peppermint • Chocolate • Alcohol • Carbonated beverages • Coffee and other caffeinated drinks MIND YOUR MEALS Certain foods and drinks may cause acid reflux in some people—pay attention to your personal triggers and learn to avoid them. Common culprits include: "[Fundoplication surgery] is a great option for many people combatting a chronic case of GERD and can put a permanent end to acid reflux." —DR. DAVID LUCAS If lifestyle changes and medications aren't working, your doctor may advise fundoplication, "a minimally invasive surgery in which a surgeon frees up the top part of the stomach, called the fundus, and wraps it around the esophagus, then secures it with a couple of stitches," Dr. Lucas explains. This reinforces the LES, so that it will no longer allow stomach acid to escape into the esophagus. To determine if surgery is a good option, your doctor will thoroughly examine your stomach and esophagus via an upper endoscopy, in which a thin, lighted tube with a camera at the tip is sent through your mouth and down into the upper digestive tract. "For many people, fundoplication is good way to find relief from acid reflux and get off medications," says Dr. Lucas. "Studies show the surgery may be better at treating esophagitis than certain medicines, as well." Fundoplication is performed in a hospital using a laparoscope—another tube outfitted with a camera. The surgeon passes the laparoscope through a small incision in the abdomen when the patient is under general anesthesia; he or she then uses surgical instruments to perform the operation through three or four more small incisions. It's all accomplished in an hour and a half or less and most patients stay in the hospital for only a day. "Though folks are usually ready to return to daily activities in a week, they must avoid heavy lifting or straining for about a month," says Dr. Lucas. For those with chronic reflux, the results of the procedure are truly life changing. "We know that about 90 percent of people remain without symptoms after 10 years," says Dr. Lucas. "Those who don't escape acid reflux entirely may need to treat symptoms with medications, but they're far better than before surgery; their quality of life has improved substantially." While heartburn is the primary symptom of GERD, not everyone experiences it. Other possible symptoms include bad breath, nausea, vomiting, pain in the chest or upper abdomen, trouble swallowing, respiratory problems, and tooth erosion. EXPLORING FUNDOPLICATION

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