Your primary care provider or pediatrician will often refer you to an ENT (ear, nose, and throat) specialist, or otolaryngologist, for evaluation, diagnosis, and treatment if you are having related symptoms.
GERD and LPR are usually suspected based on symptoms, and can be further evaluated with tests such as an endoscopic examination (a tube with a camera inserted through the nose), biopsy, special X-ray exams, a 24-hour test that checks the flow and acidity of liquid from your stomach into your esophagus, esophageal motility testing (manometry) that measures muscle contractions in your esophagus when you swallow, and emptying of the stomach studies. Some of these tests can be performed in an office.
Options for treatment include lifestyle and dietary modifications (see below), medications, and rarely surgery. Medications that can be prescribed include antacids, ulcer medications, proton pump inhibitors, and foam barrier medications. To be effective, these medications are usually prescribed for at least one month, and may be tapered off later after symptoms are controlled. For some patients, it can take two to three months of taking medication(s) to see effects.
Children and adults who do not improve with medical treatment may require surgical intervention. Surgical treatment includes “fundoplication,” a procedure that tightens the lower esophageal muscle gateway (lower esophageal sphincter, or LES). Newer techniques allow this to be done in an endoscopic or minimally invasive manner. Another surgical option uses magnetic beads to tighten the LES.
What Changes Can I Make to Prevent GERD and LPR?
For adults, you can take certain steps to reduce or prevent occurrences of GERD and LPR, including:
- Lose weight.
- Cut down or stop smoking tobacco products.
- Limit or avoid alcohol.
- Wear clothing that is looser around the waist.
- Eat three to four small meals a day, instead of two to three large ones, and eat slowly.
- Avoid eating and drinking within two to three hours of bedtime.
- Limit problem foods, such as caffeine, carbonated drinks, chocolate, peppermint, tomatoes, citrus fruits, fatty and fried foods, and/or spicy foods.