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Hello. Thank you for your question regarding gastroesophageal reflux disease (GERD).
In regards to treatment with Nexium a regimen of once every 3 days is usually not effective. I recommend proton pump inhibitors (like Nexium) to be given daily preferably 1 hour before breakfast or lunchtime meal DAILY.
In regards to lifestyle changes which are often very effective I recommend the following:
1.Elevate the head of your bed (with a brick or an adjustable bed) to > 30 degrees.
2.Avoid fatty foods/peppermintocolate/onion/garlic/alcohol. These are known GERD triggers.
I congratulate you on your weight loss and the knowledge you have acquired on this condition.
Antireflux surgery should be considered after medications have failed. That is failing once DAILY high dose PPI or twice DAILY PPI (like nexium). This does not sound to be the case. However some patients elect to have surgery to eliminate need for medications. This surgery however does not guarantee cure. There is a fair amount of patients who still need medications after the surgery and a significant amount that require a second operation if this first surgery fails. I recommend you discuss this option with your surgeon but my guidance to patients is to give once or twice daily regimens a try before thinking about this. In addition to a PPI a H2 blocker like Zantac can be added.
Although you have had an endoscopy before it was quite some time ago. I recommend you ask your physician to be tested for peptic ulcer disease (ulcer) if your symptoms continue despite 4-8weeks of twice daily PPI therapy.
In summary I recommend:
1.Talk to your physician/gastroentertologist about once or twice daily Nexium therapy for 4 to 8 weeks
2.Talk to your physician about surgical options for GERD to include antireflux surgery
3.Talk to your physician about testing for peptic ulcer disease with an endoscopy if medication fails for 4 to 8 weeks.
2014-12-29 04:32:30
David
