Acid Reflux
Acid Reflux
With various acid reflux treatments ranging from medical therapy to newer non-surgical antireflux procedures such as EsophyX or Stretta, Dr. Anthony Starpoli can help you to find the best treatment for your Acid Reflux, Heartburn, and Gastro Esophageal Reflux Disease (GERD). Dr. Starpoli specializes in endoscopic assisted, incisionless reflux therapy.
Acid Reflux Symptoms
Other Treatments for acid reflux include:
- Acid lowering drugs
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Generally, antacids buffer and neutralize acid and should be taken 30 to 60 minutes after eating and at bedtime. Liquids are preferred to tablets for immediate, but temporary relief.
The next category is histamine type II blockers such as famotidine that modulate acid production. They are available over-the-counter and in higher strengths by prescription.
The most potent acid lowering drugs are referred to as proton pump inhibitors (PPI) that shut down acid production such as omeprazole.
A newer category of acid blockers called Potassium competitive acid blockers (PCAB). A PCAB is a new class of acid suppression medications that inhibit gastric (H + K + ATPase) with a faster onset of action than PPI drugs.
The appropriate class and dosing will be decided by your reflux specialist.
- Alginic Acid and Antacids
- Two products, Gaviscon and Algicon, place a layer of foam over the fluid in the stomach to prevent reflux. These tablets should be chewed well and used 30 to 60 minutes after eating and at bedtime.
- Drugs
- Medicines are now available that effectively reduce and even eliminate the secretion of stomach acid and are the strength of the LES muscle. These medicines represent the most important method of treating reflux next to surgical or futuristic nonsurgical methods of correcting reflux. There are drugs that directly increase the strength of the LES muscle.
- Laparoscopic Surgery
- Surgery can treat reflux. Those patients who are dependent on acid lowering agents may entertain an antireflux procedure. There are patients who do not repsond to medical therapy and benefit from antireflux prcedures. Generally, however, a failure of medical therapy is not an indiction for surgery and such patients require a meticulous work-up. Prior to any corrective procedure, a patient must undergo an extensive evaluation that should include combine pH-impedance testing assessing nonacid as well as acid reflux. The objective of this surgery is to strengthen the LES muscle and remodel the gastroesophageal flap valve. Successful surgery greatly relieves and can correct severe reflux and heartburn. A method of performing anti-reflux surgery is by laparoscopic technique whereby the surgery is accomplished through tiny holes in the belly button and upper abdomen. The best known such procedure is known as the Nissen fundoplication. Recovery is quicker with this laparoscopic technique. However, the procedure is still an invasive surgery that has certain inherent risks and potential complications, and requires the use of general anesthesia. This operation should only be performed by qualified and experienced surgeons thoroughly familiar with it. In addition to the Nissen procedure, is the LINX Reflux Management System whereby a magnetic bracelet is surgically placed around the lower esophagus to augment the performance of the lower esophageal sphincter and strengthen the anti reflux barrier.
- Transoral, Incisionless Antireflux Surgery (TIF)
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I am pleased to present incisionless, endoscopic methods for the treatment of reflux are now available. I offer two incisionless, endoscopic assisted procedures: EsophyX and Stretta. EsophyX, also known as the TIF procedure, is a transoral(i.e. performed through the mouth) incisionless, surgical procedure that is endoscopic assisted and applies suture-like fasteners that bring together esophageal and gastric tissue to remodel the antireflux barrier and gastroesophageal flap valve with a result that is very similar to the formal laparoscopic surgical fundoplication. Learn more about TIF
- A Frequently Asked Question?
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This instrument assembly allows the endoscopist to carefully place stitches in the stomach below the LES (ie. junction between the esophagus and the stomach). The application of these sutures produces a pleat in the upper part of the stomach which helps reduce the pressure against the LES and decreases the amount reflux. With both of these procedure there are no surgical incisions and recovery is quicker.
The Stretta procedure uses radiofrequency energy to build up the muscle of the lower esophageal sphincter. Learn more about Stretta
Acid Reflux Treatment
Treatment for Acid Reflux Disease
• General measures the patient can take to reduce reflux are:
• Eat smaller and more frequent meals.
• Avoid eating before going to bed.
• Eliminate excessive bending, lifting, abdominal exercises, girdles and tight belts, all of which increase abdominal pressure and provoke reflux.
• If overweight, lose weight. Being overweight promotes reflux.
• Eliminate the use of nicotine (cigarettes), fatty foods, alcohol, all coffees (yes-including decaf), chocolate and peppermint.
• Elevate the head of the bed 8" to 10" by placing pillows or a wedge under the upper part of the mattress. In this way, gravity keeps stomach juices out of the esophagus while the patient sleeps. It is not enough to use two pillows under the head.
• Prescription medications - check with the physician regarding side effects of prescription drugs. Some drugs actually lower the strength of the LES muscle. These include anti-spasmotics (Levsin, Librax, Bentyl), calcium channel blocks (Procardia, Cardizem, Calan, Isoptin), anti-depressants (Elavil, Doxepia) and others.
For Acid Reflux Repair
Endoscopic Assisted, Incisionless Therapy For GERD
Endoscopic Assisted Reflux Therapy including EsophyX (TIF) and Stretta are exciting incisonless surgical methods used by Dr. Anthony Starpoli to treat Gastro Esophageal Reflux Disease (GERD). This treatment is a breakthrough alternative to life-long medical therapy or invasive and costly surgery.
If you would like to find out more about solving your reflux and heartburn problems using non-invasive, incisionless procedures such as EsophyX (TIF) or Stretta.
80 5th Ave. Suite 1605 New York, NY 10011
55 Montgomery St. Poughkeepsie, NY 12601
212 673 2721 845 471 1354
info@starpoli.com
55 Montgomery St. Poughkeepsie, NY 12601
212 673 2721 845 471 1354
info@starpoli.com
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