Daily Pills or a Real Fix? Understanding Your Long-Term Options for Acid Reflux

For many, the burning sensation of heartburn after a rich meal is an occasional annoyance. But for millions of Americans, acid reflux, or Gastroesophageal Reflux Disease (GERD), is a daily battle. If you're constantly reaching for antacids or daily prescription pills, you might be wondering: is this truly the best long-term solution?

The answer, increasingly, is no. While medications offer relief, they often mask the underlying problem rather than fixing it.

The Problem with the Pill: Why Long-Term Medication Isn't Always the Answer

For decades, the go-to solution for GERD has been medication, primarily proton pump inhibitors (PPIs) like omeprazole or lansoprazole. These drugs work by reducing the amount of acid your stomach produces. And for many, they provide welcome relief from symptoms.

"Historically, the approach has been to use antacids, medications that reduce the amount of acid in the stomach," explained Dr. Kalpesh Patel, a gastroenterologist at St. Luke's Health - Sugar Land Hospital. "Those were never designed to be used long term, but that became sort of the practice out of convenience."

The convenience of a daily pill overshadowed a crucial question: at what cost? Our bodies produce stomach acid for important reasons. "Using a medication to suppress acid, you're turning off a natural part of the body, a natural function of the body," Dr. Patel said. "Acid is actually normal to have. You need it for absorbing minerals and vitamins, and it's a natural antibiotic in our system."

Over time, suppressing this natural function can lead to unintended consequences. "By stopping the acid for many, many years, now we're starting to see side effects," Dr. Patel noted. These can include issues with nutrient absorption, bone effects (especially concerning for women), and altered gut microbiome balance.

The Real Root of the Problem: An Anatomical Issue

For many suffering from severe or persistent GERD, the issue isn't just "too much acid." It's often an anatomical one, specifically a hiatal hernia. This occurs when a portion of the stomach pushes up through an opening in the diaphragm, disrupting the natural anti-reflux mechanisms of the body.

"The reason people may have severe or more persistent acid reflux is actually due to an anatomical issue having to do with the orientation of the stomach and how it attaches to the esophagus," Dr. Patel explained. "The body naturally is designed to kind of have its own anti-acid reflux mechanism, but this is what fails in patients who have daily or severe symptoms." The more familiar term for this, he added, is having a hiatal hernia.

Beyond Medication: A Restorative Approach to Reflux

At St. Luke's Health in Sugar Land, our specialists offer a more comprehensive, restorative approach for patients whose GERD is tied to a hiatal hernia. “Instead of merely suppressing symptoms, we address the root cause and restore the body's natural function,” said general and bariatric surgeon Dr. Brandon Fadner.

"The best thing about this approach is that it is collaborative,” said gastroenterologist Dr. Fares Ayoub. “Instead of one doctor, you have two experts thinking about you and formulating a joint plan of care personalized to your own body and anatomy."

This unique, collaborative approach utilizes modern, minimally invasive surgical techniques that lead to relief from GERD and discontinuation of acid suppressive therapy for up to 94% of patients, according to a study published in Surgical Endoscopy, co-authored by Drs. Ayoub and Patel among other collaborators.

The innovative strategy, called a cTIF procedure (concomitant hiatal hernia repair and transoral incisionless fundoplication) includes two key components performed in the same session by experts at St. Luke’s - Sugar Land, including Dr. Fadner, Dr. Patel, and Dr. Fares Ayoub:

1. Laparoscopic Hernia Repair: A minimally invasive surgical repair to fix the hiatal hernia, tightening the diaphragm where it has loosened.
2. Transoral Incisionless Fundoplication (TIF): Following the hernia repair, an endoscopic device (inserted through the mouth) is used to reshape the stomach from within, reinforcing the weakened valve between the esophagus and stomach.

"By combining the two approaches, you actually get the best long term result," Dr. Fadner explained. This combined procedure—performed at St. Luke's Health Sugar Land at a higher volume than anywhere else in Houston—is about restoration of health and well-being.

The benefits are significant:

• Dramatic Symptom Relief: Most patients are able to discontinue daily medications soon after the procedure.
• Restored Normal Function: Patients can swallow and belch naturally and avoid the constant feeling of fullness often associated with older surgical procedures.
• Long-Term Efficacy: While not a "cure-all," studies show excellent long-term results, with a vast majority of patients medication-free and symptom-free at five years.

Is a "Real Fix" Right for You?

If you've been battling GERD for years, relying on daily pills, and suspect there might be a better way, it's time to explore your options. Don't settle for lifelong medication that only manages symptoms. Discover if a restorative solution can bring you lasting relief and a better quality of life.

Ready to explore your long-term options for GERD? Contact the General & Bariatric Surgery Clinic at Baylor St. Luke's Medical Group in Sugar Land, Texas, at (281) 637-9000 or find a doctor near you to schedule a consultation with our experienced gastroenterology and surgical team.