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What is the treatment for my GERD problem?

Q: I am 34 years old and recently my food pipe got blocked. I could not eat for 2-3 days. After going to the doctor multiple times, he said that it is because of acid reflux. He prescribed me medicines apart from the omeprazole(Prilosec), which I was taking. But the medicine which he gave did not work and my problem worsened with huge pain and heartburn. Ultimately, after a week it settled down. Now I am taking Nexpro-40 and Nexpro-20 (one each) in the morning and evening. I am back to my regular diet from the bland diet I was taking. I have raised my bed and eat very early before sleeping. I had this heartburn for years together, but never bothered as much, since Tums and Digene used to help me for the short term. My gastroenterologist did an endoscopy and said that there is corrosion on my oesophagus and asked me to continue taking Prilosec-20 (two tablets every 12 hours). Can I continue taking Nexpro. If yes, for how long? Is there a permanent solution for this or I have to live lifelong with this problem? How bad is Barrett's oesophagus? Is there a cure for it?

A:Your gastro-oesophageal reflux needs definite control by the drugs which help you best, and the treatment generally should be considered on a regular long-time basis, that is, when your symptoms get controlled you need to take a small dose for maintenance to prevent symptoms. The drugs are beneficial to reduce the acidity of the refluxate. Regular endoscopic monitoring will help to study oesophageal mucosal healing. If there is a definite hiatus hernia, surgery can be considered and this should prevent long-term medication. Barrett's oesophagus is a chronic condition where the healing oesophagus develops different mucous membrane, and if confirmed you would need long-term drug therapy and annual endoscopic/biopsy monitoring as rarely malignant changes can occur.


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