Suggest Treatment For Severe Acid Reflux While On Omeprazole

Brief Answer:
Please see detailed answer.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query,

As per your query;Firstly i would suggest you to switch over to Nexium(Esomeprazole),Initially take it 40mg twicedaily,However if not relieved doses can be increased to 80mg twice a day.Though Esomeprazole is of the same class as Omeprazole yet trials shows it is superoir to other PPI's in treating reflux disorder.
Other then that ask your gastroenterologist to add Prokinetic drug like
Levosulpride;It is a sulpride isomer and exerts its prokinetioc effect by blocking D2 receptors,Recent studies have shown that combining it with Rabeprazole has shown good effect in patients suffering from GERD.

Domperidome-Very effective in treating GERD when combined with Rabiprazole.

Acotiamide-Trials showed that 30mg doses taken for 3 month thrice daily were highly effective in treatment of of functional dyspepsia.The positive effect of acotiamide on both gastric emptying and gastric accommodation,Gastric accommodation and gastric emptying in acotiamide group were significantly enhanced in people taking it.

-Baclofen- normally used for cerebral palsy patients and patients with other neuromuscular diseases.It has been successfully used in patients with reflux.It may decrease the frequency of relaxations of the lower esophageal sphincter and therefore decrease gastroesophageal reflux.

Please discuss all these options with your gastroenterologist.
Test advice-
Endoscopy to examine the inner part of the oesophagus.
Ambulatory acid test for monitoring the amount of acid within the oesophagus.


Apart from that drastic life style modification and dietary changes are required-
Firstly stop taking soda or any aerated beverage.
Food and beverages like chocolates, fatty food, coffee, alcohol and peppermint should be avoided in order to reduce the weakening of the lower oesophageal sphincter. Several food items irritate the damaged oesophageal lining and should also be avoided. They include citrus fruits, tomato and pepper.
Smoking cigarettes results in weakening of the lower oesophageal sphincter and should be stopped to reduce GERD.
-Take about 30 grams of fibre daily in your diet.Eat one cup of fresh fruits(except banana) and half bowl of green salad daily;this will meet your extra total fibre requirement.Avoid cirus fruits as they can increase symptoms.
- Avoiding alcohol.
-Exercise daily for 20 minutes at least.
-Avoid oily and spicy food.
-Drink COLD milk.
-Yogurt is a very good natural source of probiotic take it daily.
Adhering to both medicines and Strict life style changes will help you in long term.
-Last but not the least ,Keep yourself fully motivated.
I hope I was helpful. I am happy to help if you have follow-up questions.
Regards.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
As per your query,
Two best points are
1)Start you on levosulpride along with Rabeprazole.
2)Consider adding Acotiamide in thrice daily dosage for 3 months.
Both of them are highly efficient drugs and can play wonders.

Regards and Good luck.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Please discuss the doses with your Gastroenterologist as that is not allowed by HealthcareMagic.

However commonly Gastroenterologist prefer to use -
Levosulpiride 75 mg along with Rabeprazole 20mg once before breakfast.
Tab Acotiamide 100 to 300mg daily in three divided doses(before taking food).
Regards

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