Complex. I think that reflux is a complex disease and more a mechanical problem. It could be transient but when it persists it should be carefully studied and addressed accordingly. Medications are the first line and then surgical procedures can be considered. Medications only address the symptoms and do not correct the problem. See your doctor. Don't just take over the counter meds.
Depends. As in most health problems, treatment should be specific to the root of your disease. Gerd can be managed conservatively with diet, behavior modification and occasional medication for most patients but some do require aggressive intervention (including surgery) if reflux injury is prolonged or tissue transformation noted. If in doubt, please see your doctor.
Hard to say. This is where medicine is more art than science. If by cure you mean no more heart burn, we are almost there. Reflux, however, is a physiologic event that will happen under many common settings (large meal, carbonation, muscle relaxant, poor gastric emptying / full stomach...). The best reflux rx is actually a combination of wise dietary selection, good lifestyle and medical attn as needed.
There already is!!! Minimally invasive anti-reflux surgery repairs the failed natural anti-reflux valve at the top of the stomach and cures reflux disease with 95% effectiveness. The most common procedure is called lap nissen fundoplication which involves wrapping the top part of the stomach around itself to create a robust valve that prevents reflux. Experienced surgeons have shown over 10 year durability.
1. Bland diet, low in acidic foods like citrus, tomatoes etc, high fat diet like cheese, fried food, red meat etc, no or low caffeine, no alcohol or smoking and avoiding lifting and stooping etc.
Unlikely. While there are potentially life threatening complications from gerd, these are very rare, and include aspirating stomach fluid in the lungs and the development on cancer. These complications would only occur if there is some sort of underlying neurological or respiratory disease, an longstanding gerd (>10 years). To put it in perspective, you stand a greater chance of dying in a car accident.
Unlikely. Long term effects of untreated or inadequately treated gerd can include narrowing, scarring, and increased risk for esophageal cancer. Esophageal cancer is a bad disease, kills people. Most people with gerd don't get that.
Yes. Chronic reflux is the main cause of esophageal adenocarcinoma. It is the fastest growing cancer in the U.S. Hiatal hernias tend to make reflux worse. The important thing is to have an endoscopy to get checked.
Several. Upper endoscopy, upper GI and manometry. Bravo probe if not clear cut symptoms and findings on egd.
Sx & response to Rx. Most commonly diagnosed by clinical history with typical symptoms and relief with medication. Endoscopy and ph monitoring may aid in the diagnosis but are by no means necessary.
Testing. I believe that symptoms are a good blue to gerd but I think that egd, and posibly oh probe are the best way to characterize the degree of reflux and severity of damages. I would add to that an UGI and gastric emptying. The symptoms of gerd can be due to several conditions. If one just uses symptoms as the diagnostic tool, I would not treat medically for longer than 4 weeks. It can be serious.
Clinical history. Symptoms with a repose to treatment is way most people are diagnose with gerd. If there are questions about the diagnosis invasive testing such as endoscopy, hr-mano, ph can be considered.
Acid in Esophagus. Gastric=stomach & upper 2/3 lined with cells which secrete hydrochloric acid (inhibits bacterial growth) under brain control. With healthy subconscious control of esophagus, bottom of esophagus only relaxes as solid/liquid is pushed down. If stomach contents repeatedly pushed back up, esp. When lots of acid present, then esophagus damaged over time; can eventually promote esophagus cancer.
Reflux. Refractory gerd means reflux disease not responding to standard treatment and conservative measures.
Agree. Agree with dr. Vijay laxmi misra. When describing refractory gastroesophageal reflux disease, generally speaking of patients still suffering symptoms of acid reflux despite standard medication therapies with appropriate lifestyle changes.