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In a patient with GERD diagnosed 5 years ago who has been on proton-pump inhibitors and an H2 blocker, both 2x daily since then with a lot of symptoms still occuring, what other treatment options remain besides nissen fundoplication or possible hiatial hernia surgery?
First Prevacid 30mg was tried for several years, and now the patient is taking Nexium 40mg twice every day. Caffeine is being avoided, as is carbonation and other triggers. He still has reflux symptoms in the evening about 10 hours after taking first PPI, and 3 after taking second.
No tests like manometry or pH testing have been done. I was just wondering what treatment options are left, and what kind of future lies ahead. There is probably a higher risk of esophageal cancer, but what other complications can come from this? Is it possible to be fed through a stomach tube or IV, or would this cause symptoms too?
I'm a pre-med, so I don't have a lot of GI experience, and I know that any advice on this forum comes from mostly students and residents, but I was still curious to know whether anyone had encountered difficult to treat GERD, and what could be done about it. My best friend's dad is going through a difficult time right now.
Thanks for any help!
First Prevacid 30mg was tried for several years, and now the patient is taking Nexium 40mg twice every day. Caffeine is being avoided, as is carbonation and other triggers. He still has reflux symptoms in the evening about 10 hours after taking first PPI, and 3 after taking second.
No tests like manometry or pH testing have been done. I was just wondering what treatment options are left, and what kind of future lies ahead. There is probably a higher risk of esophageal cancer, but what other complications can come from this? Is it possible to be fed through a stomach tube or IV, or would this cause symptoms too?
I'm a pre-med, so I don't have a lot of GI experience, and I know that any advice on this forum comes from mostly students and residents, but I was still curious to know whether anyone had encountered difficult to treat GERD, and what could be done about it. My best friend's dad is going through a difficult time right now.
Thanks for any help!