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What is the Treatment for a Loose Esophageal Sphincter?

By Clara Kedrek
Updated Mar 03, 2024
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A loose esophageal sphincter can result in gastro-esophageal reflux disease (GERD), where food and stomach acid flow back 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.

The first line of treatment for a loose esophageal sphincter involves making lifestyle modifications that help prevent the symptoms of GERD: heartburn, problems swallowing, chest pain, and nausea. Affected patients are advised to avoid spicy, acidic, or fatty foods. Alcohol use and smoking are also discouraged. Patients should eat small meals, and drink plenty of water with their meals. They should avoid eating close to bedtime, and should sleep with the head of their bed raised.

The next step in the treatment of a loose esophageal sphincter is medication. The most effective medications function by decreasing the secretion of acid in the stomach. Two classes of antacid medications that are especially helpful include the H2 blockers and the proton pump inhibitors (PPIs). These medications are available either over-the-counter or by prescription, and are typically taken daily regardless of symptoms.

If the antacid medications alone are not effective in decreasing reflux symptoms, other adjunct 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 the eradication of the bacteria Helicobacter pylori from their gastrointestinal tract with a course of antibiotic medications.

Failure of medical therapies could suggest a need for surgery. A variety of procedures can tighten the lower esophageal sphincter and prevent reflux. The most common surgery performed to treat a this condition is the Nissen fundoplication, a procedure that can be done with either laparoscopic or open surgery. Other procedures used to fix the lower esophageal sphincter include the Hill gastropexy or a gastric bypass surgery.

A loose esophageal sphincter can be diagnosed by performing a number of procedures. Monitoring the pH of the lower esophagus over a period of 24 hours can point to acid reflux; patients with this condition have lower-than-expected pH values. The technique of esophageal manometry can measure the pressure at the lower esophageal sphincter. Endoscopy, which is performed by inserting a flexible tube with a camera into the esophagus, allows doctors to visualize the lower esophageal sphincter. Other times, patients are given a presumptive diagnosis of GERD based on clinical history alone.

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Discussion Comments

By anon990517 — On Apr 25, 2015

You don't need stomach acid to digest food. The stomach acid is not there to digest food. It serves another purpose.

Other guy: look into ammonia breath. You may have a problem with your kidneys.

By anon339819 — On Jun 27, 2013

I don't have an idea what I'm suffering from. I experience a very bad smell oozing from my mouth when I speak. I have been to the dentist, ORL and Gastroenterologist, and after a series of examinations, treatments and reexaminations, I have been given a clean bill of health, yet the problem persists. Kindly help me please.

By Banna — On Dec 31, 2012

In addition to the symptoms mentioned, I face one extra sad one: Continuous hiccups! One of the times I have had a nonstop hiccups for four days (once every five seconds) and the only thing that stopped it was a pill called Haldol that caused many side effects.

At first, I thought that the hiccups were causing the reflux, but after I had an endoscopy, it turned out that my "GERD" is causing all this and I am still trying some antacids and changes in my diet. It's a very hard thing to do, but compared to having these terrible hiccups, anything seems promising.

If the antacids don't help, I will have to go through the surgery option because my condition seems really bad.

@Misscoco: I think the antacids are recommended because in our case of "GERD", the acid enzymes produced by the stomach flow backward to the esophagus, causing the heartburn and the other symptoms. And by taking antacids, we are trying to relieve the esophagus not the stomach. Or something like that. Good luck everyone!

By kylee07drg — On Sep 08, 2011

It can be so hard to change your diet, even if the food you eat is making you miserable afterward. I ate a lot of spicy, fatty foods, and I paid for it with acid reflux.

I took antacids, but they didn’t do much good. My sister even let me try her prescription antacid, and I still had the reflux. I knew I needed to change my diet.

I started eating more bland foods. At first, I really missed my spicy fried chicken and jalapeno hamburgers, but after awhile, I learned to love parsley roasted chicken and steamed vegetables. My acid reflux went away, and I lost a few pounds!

By shell4life — On Sep 07, 2011

My best friend was having a lot of severe heartburn. He had tried prescription medicine, but nothing seemed to prevent it. He even quit eating citrus fruit, which he loved, but to no avail.

He decided that he should go ahead and have surgery. He was tired of hurting and burning. His doctor also thought surgery would be his best option.

He had to be put to sleep for the operation. The surgeon used a laser to reposition the top part of his stomach around his esophagus. This would strengthen his esophageal sphincter.

After a short recovery period, my friend noticed that his heartburn was gone. He could eat oranges and grapefruit again, and he was so happy!

By sweetPeas — On Sep 06, 2011

@misscoco - That is a good question that you ask. I've done a little reading on the subject, but I don't know the full answer. It may be when people have acid reflux, they have excess acid in their stomach.

Their lifestyle habits might be causing the extra acid. Eating spicy, fatty and heavy foods might be the cause. Or maybe drinking too much alcohol, caffeinated drinks and smoking may be the culprits.

Anyway, my guess is that people with acid reflux have more acid than they need to absorb nutrients and they also have a loose esophageal sphincter. So they may need medication to prevent an excess of stomach acid.

By Misscoco — On Sep 06, 2011

Several people in my family have been diagnosed and treated for loose esophageal sphincter. It really is a very uncomfortable disorder. If I eat food like dry rice or bread, the opening between my throat and esophagus doesn't open wide enough, and I can't swallow.

Then the stomach acid churns up from my stomach into the esophagus tube. I just have to sit and relax, waiting for things to settle down. I do take medicine, but sometimes it doesn't work.

My question is - why does a doctor prescribe an antacid for acid reflux stomach when you need stomach acid to help you digest and absorb your food?

By Sinbad — On Sep 06, 2011

@snickerish - GERD in babies can occur, and although I am no expert (my nephews had it as babies and took medication for it so I learned a bit about it) I know it can be caused by a uncoordinated gastro-tract, which may be a bit different than GERD in other older populations.

One of the symptoms my family saw in my nephews as symptoms was regurgitation of food and then re-swallowing it.

Other symptoms include vomiting that occurs frequently as opposed to an isolated incident, frequent coughing, a child often crying and being fussy, as well as refusing to eat or difficulty eating.

The last symptom (refusing to eat or difficulty eating), I think is a tricky one because I learned in speech pathology school that there could be many reasons for refusing to eat or difficulty eating in babies (we learn a lot of the swallowing mechanism in speech pathology graduate school secondary to our responsibility to diagnose swallowing disorders).

So if refusing to eat or difficulty eating is the only symptom, I would get at least a few different opinions on the causes of that symptom!

By snickerish — On Sep 05, 2011

In working with children with disabilities both physical and intellectual disabilities that are often fed by caregivers, I feel the need to also mention with gastric reflux the need to have these children checked out for GERD.

This is because of the complex disorders, there are so many things that are looked at that it is sometimes easy to overlook and because many of these children are nonverbal it is difficult to tell if they are having any of the effects of reflux, whereas a child who can talk can tell you that they feel some burning or a lump (which are common ways to describe reflux).

And always, always remember to (just as the article mentioned) to keep a child upright after feeding them so that gravity is their friend in digestion!

Now I have seen some of our older kids be diagnosed with a loose esophageal sphincter disorder, but I have also wondered does GERD in babies occur?

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