A loose esophageal sphincter can result in GERD.
A loose esophageal sphincter can result in gastroesophageal reflux disease (GERD), where food and stomach acid flow back up into the esophagus, causing heartburn and other symptoms. The problem and related condition can be treated in a number of ways. Many patients benefit from making lifestyle changes and taking medications. Severe disease can be alleviated with surgery.
Surgery for a loose esophageal sphincter is often performed laparoscopically.
The first line of treatment for a loose esophageal sphincter involves making lifestyle modifications that help prevent the symptoms of GERD: heartburn, trouble swallowing, chest pain, and nausea. Affected patients are advised to avoid spicy, acidic, or fatty foods. The use of alcohol and tobacco are also discouraged. Patients should eat small meals and drink plenty of water during meals. They should avoid eating close to bedtime and sleeping with the head raised.
Patients suffering from loose esophageal sphincter may need a feeding tube.
The next step in treating a loose esophageal sphincter is medication. The most effective medications work by decreasing acid secretion in the stomach. Two classes of antacid medications that are especially helpful include H2 blockers and proton pump inhibitors (PPIs). These medications are available over-the-counter or by prescription and are usually taken daily, regardless of symptoms.
GERD can cause nausea and vomiting.
If antacid medications alone are not effective in reducing reflux symptoms, other ancillary medications can be used to treat a loose esophageal sphincter. Some options include prokinetic agents such as metoclopramide and reflux inhibitors such as lesogaberan. Other patients benefit from eradicating the Helicobacter pylori bacteria from their gastrointestinal tract with a course of antibiotic medications.
Antacid medications can be effective in relieving reflux symptoms.
Failure of medical therapies may suggest the need for surgery. A variety of procedures can constrict the lower esophageal sphincter and prevent reflux. The most common surgery performed to treat this condition is a Nissen fundoplication, a procedure that can be done with laparoscopic or open surgery. Other procedures used to correct the lower esophageal sphincter include Hill’s gastropexy or a gastric bypass surgery.
Smoking is discouraged for someone undergoing treatment for a loose esophageal sphincter.
A loose esophageal sphincter can be diagnosed through several procedures. Monitoring the pH of the lower esophagus over a 24-hour period may indicate acid reflux; patients with this condition have lower than expected pH values. The esophageal manometry technique can measure the pressure in the lower esophageal sphincter. Endoscopy, performed by inserting a flexible tube with a camera into the esophagus, allows doctors to view the lower esophageal sphincter. Other times, patients are given a presumptive diagnosis of GERD based on medical history alone.