What are the best ways to treat GERD due to obesity?

Question

Hi doctor,

I am a 28-year-old male. My height is 5 feet and 8.9 inches, and I weigh 227.076 pounds. My abdomen is swollen like a dome. I have GERD grade B (LA classification), lax cardia, prolapse gastropathy, gastritis, and moderate erythema of the gastric mucosa with erosions. That is what the endoscopy report says I did a few days ago, and the colonoscopy says everything is normal. I am very weak at doing plank and twisting exercises that target my abdominal muscles. I have also been having consistent coughing the past few days. Whenever I gargle with tap water or brush my teeth, I either vomit or nearly vomit.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your case history and attached images (attachments removed for patient identity protection) of your endoscopy report and your abdomen.

Your primary issue is obesity, causing or exacerbating your other issues. In your case, gastroesophageal reflux disease (GERD) is due to obesity and lax lower esophageal junction, as mentioned in the endoscopy report.

For this, I would like to suggest

Do not fill your stomach at once. Keep some space in your stomach by having small, frequent meals rather than one large meal.
Do not sit or lie down immediately after meals; walk for 5 to 10 minutes post-meals.
Your dinner should be three hours before sleep or going to bed. Elevate the head of your bed to around 20 to 25 degrees with the help of bricks or wooden pieces at the bottom of the head of your bed (do not use extra pillows to elevate your neck; this will cause neck pain).
You must be on acid suppression medicine like Pantoprazole 40 milligrams, half an hour before breakfast, for two to four weeks. Antacid syrups like Gaviscon or Bismol, after every meal, reduce the symptoms of heartburn.
Most importantly, do regular exercise and reduce your calories to cut down your weight slowly but steadily, and target your body mass index to near 25. This likely takes a couple of months, but it is the best possible treatment for most of your symptoms in the long run.

Wishing you good health.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

No, I do not think it is intra-abdominal pressure. Raising intra-abdominal pressure is a different issue. We have seen that in hospitalised sick patients because of different reasons.

You have truncal obesity, causing external pressure or compression to your stomach. That is why gastroesophageal reflux disease (GERD) and lax lower esophageal junction are more common in obesity. As I already mentioned, weight reduction and diet modification points will help you a lot.

Wishing you good health.

Thank you.