Question: I have been diagnosed with gastritis and GERD, but am not responding to Protonix. What other treatments are available?

Dr. Hibberd's Answer:

Any GERD (gastroesophageal reflux disease) that has been documented by endoscopy can be treated with additional medications to try to increase the sphincter tone between the esophagus and the stomach. Cases of delayed gastric emptying will respond to medications that speed digestion.

Many patients with GERD are undiagnosed or have co-existing conditions. I always encourage patients to be sure they have been thoroughly evaluated for conditions that can mimic GERD.

Conditions that may mimic GERD include motility disorders of esophagus, coronary artery disease, and angina. Tissue disorders adjacent or near the esophagus, which include tumors and infections in the esophagus, trachea, lungs, heart, lymphatic tissues, etc., may also mimic GERD.

Failure to respond may mean you need more aggressive management, or perhaps you have a co-existing condition that needs to be managed as well.

Do not forget that the best way to treat GERD is with sensible lifestyle management, weight management, small frequent food portions, elimination of foods that delay gastric emptying, and elevating the head of your bed at night to reduce passive reflux.

Severe cases may be managed by surgery that can often by done by laparoscope (keyhole) surgery for reflux that fails medical management.