- 1). Adjust your diet. Reduce or eliminate the intake of alcohol, coffee, sugar, onions, chocolate, peppermint and spearmint, all of which can weaken the LES.
- 2). Consult with your doctor about certain drugs that weaken the LES. Bronchodilators, channel blockers, beta-blockers, anti-anxiety drugs, nonsteroidal anti-inflammatory drugs and nitroglycerine relax the muscles around the LES. If you are taking these drugs as treatment for other conditions, check with your doctor about alternatives.
- 3). Consider prokinetics. Prescription prokinetic drugs such as bethanechol (Urecholine) and metoclopramide (Reglan) help strengthen the LES.
- 4). Nissen fundoplication surgery is another option. In this procedure, the upper part of the stomach is wrapped around the LES to strengthen it, prevent acid reflux and fix the hiatal hernia. It can be performed as an open surgery or as a minimally invasive surgery called laparoscopic surgery. In the first case, an incision of about 8 inches is made into the abdomen. In the second case, a thin telescope connected to a video camera is inserted through half-inch incisions in the abdomen. Typically, patients are released four to seven days after the open surgery and on the first or second day after laparoscopic surgery.
- 5). Another technique is endoscopic surgery. Certain endoscopic surgery procedures allow the surgeon to put stitches in the LES to create pleats that can help strengthen the muscle. Another type uses electrodes to create tiny burns on the LES. When the burns heal, the scar tissue helps toughen the muscle.
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