Symptom Finder - Treatment of Gastroesophageal Reflux Disease
GASTROESOPHAGEAL REFLUX DISEASE
1. Avoid caffeinated beverages, chocolate, alcohol, nicotine, and milk and milk products.
2. If obese put patient on weight reducing diet.
3. Elevate head of bed on 4–6 in blocks. (It is not sufficient to simply sleep on 2 or 3 pillows.)
4. For the acute phase, prescribe omeprazole (Prilosec): 20–40 mg daily in am or other proton pump inhibitor If patient needs more than 6 weeks of therapy, then they are
not following orders 1, 2, and 3.
5. If proton pump inhibitors unsuccessful, try cimetidine 800 mg bid or ranitidine 150 mg bid.
6. Sometimes the addition of metoclopramide (Reglan) 5–10 mg before meals and h.s. will resolve the problem.
7. If all above measures fail, consider referral to an abdominal surgeon for fundal plication and other surgical procedures. Remember a surgeon is unlikely to operate on obese patients.
1. Avoid caffeinated beverages, chocolate, alcohol, nicotine, and milk and milk products.
2. If obese put patient on weight reducing diet.
3. Elevate head of bed on 4–6 in blocks. (It is not sufficient to simply sleep on 2 or 3 pillows.)
4. For the acute phase, prescribe omeprazole (Prilosec): 20–40 mg daily in am or other proton pump inhibitor If patient needs more than 6 weeks of therapy, then they are
not following orders 1, 2, and 3.
5. If proton pump inhibitors unsuccessful, try cimetidine 800 mg bid or ranitidine 150 mg bid.
6. Sometimes the addition of metoclopramide (Reglan) 5–10 mg before meals and h.s. will resolve the problem.
7. If all above measures fail, consider referral to an abdominal surgeon for fundal plication and other surgical procedures. Remember a surgeon is unlikely to operate on obese patients.
