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Hello Thank you for your question. Gastroesophageal reflux (GER; when gastric contents move from the stomach to the esophagus) is not a disease. It occurs normally. GER DISEASE or GERD has a wide spectrum of disease and is probably one of the most common diseases of mankind. In regards to your first question I would wonder why you believe you have too "low of stomach acid"? Do you mean too low of stomach pH (which actually means more acid)? Regardless the amount of acid is not the issue. GERD occurs when there is a failure to the normal anti-reflux mechanisms which doesn't only rely on how much acid but on other factors like the pressures of the lower esophageal sphincter and other anatomical factors ("the way the parts are built"). There are 3 major defenses against acid damage. The first is a complex region involved the lower esophageal sphincte (LES) (opening between esophagus a part of the diaphragm and some ligaments and another part of the LES). The second is the ability of the esophagus to clear the acid that refluxes. The last defense is the stomach's role which relates to your question. This is the actual amount of acid secreted. However it has been proven that gastric (stomach) acid secretion is NORMAL in patients with GERD. Pepsin AC (famotodine) is an H2 blocker. I generally recommend H2 blockers and antacids (like Gaviscon others) for the patient with mild or intermittent symptoms. If they get symptoms like heartburn 2 or more days per week I recommend over the counter (OTC) omeprazole (trade name Prilosec) instead for 14 days (every day even when they don't have the symptoms). I tell them to take it 1 hour before their AM or lunch meal. If that fails to relieve their symptoms I either intensify their therapy with twice daily treatment or refer them for an upper endoscopy to look for complications of GERD or for an alternative diagnosis like an ulcer. However there are variations on this that I individualize for the patient but this is my general approach. Lifestyle and food choices are key. Elevate the head of the bed while sleeping avoid lying flat for 3 hours after meals sleep with the left side of your body down. Also avoid large fatty meals. Avoid foods that trigger GERD like onions garlic alcohol chocolate etc). Thank you

2014-12-29 04:53:19

David