I'm a 48-year-old woman with a long history of GERD. I've tried multiple medications, with Prilosec at 40mg a day being the one that works best. My chiropractor wants me to try an alternative approach to treating the GERD. He recommends stopping the Prilosec and using a natural supplement, mainly raw pancreas concentrate, for a month to heal the stomach, and then taking a supplement with betaine hydrochloride and vitamin B-6. I am afraid to stop Prilosec since it is working, but I would love the heartburn to go away altogether.

Anne

Gastroesophageal reflux disease (GERD), which occurs when acid from the stomach backs up into the esophagus, is a common ailment in our society. The symptoms commonly seen with GERD include heartburn and an acid taste in the back of the throat.

Most patients with GERD have a mild form. They may take over-the-counter medications such as antacids or the acid-suppressive medications cimetidine (Tagamet HB) or famotidine (Pepcid AC). Patients with more severe symptoms -- often those who do not get relief from over-the-counter medications -- may seek medical help. These patients may require more complete acid suppression. The most effective medications for this purpose are proton-pump inhibitors (PPIs), such as omeprazole (Prilosec) and lansoprazole (Prevacid). These medications are usually taken once a day, but some patients with very severe reflux may need twice-daily dosing. PPIs are extremely effective in reducing stomach acid and will greatly improve or eliminate GERD symptoms in more than 85-90 percent of patients.

It must be emphasized that GERD often is a chronic disorder in which suppressive doses of medications will have to be taken for long periods of time. Thus, although symptoms may resolve soon after starting PPI therapy, a daily dose of medication may need to be taken to prevent recurrence of GERD.

I am not aware of any alternative or herbal approach to treating GERD, such as the ones you mentioned. PPI therapy is safe and effective and is the best medical treatment currently available for GERD.

The only way to cure GERD at this time involves a surgical approach known as fundoplication. In this procedure, the upper stomach is wrapped around the lower esophagus to strengthen the barrier that prevents stomach acid from washing up into the esophagus. This is an option for some patients who get relief with PPI therapy but who do not want to take such medications indefinitely.