More Ways We Care for Our Patients

Gastroesophageal reflux (GERD) is very common and has symptoms such as chest pain or burning and is typically brought on after a fatty meal or alcohol. It is often relieved with Maalox and tums. It is commonly treated with acid-reducing medicines. Here are some non-pharmacologic techniques to try if you suffer from GERD:

1. Do not eat within 3 hours of going to bed (and lying flat). In other words, stay upright after eating.

2. In bed, sleep with a 30 degree incline (a wedge can be used) -- but be careful so as not to bring on sleep apnea.

3. Limit fatty food and alcohol in the evening.

4. Do diaphragm breathing exercises:

   • Place one hand on your chest, and one hand on your abdomen.

   • Inhale slowly and fully and aim to keep the hand on your chest from moving -- so only your abdomen is expanding as you inhale.

   • Exhale slowly similarly keeping your chest from moving.

   • Do 5-10 reps and do this throughout the day, e.g. 3 times.

5. Maintain a healthy weight (increased abdominal weight means increased abdominal pressure which increases the pressure on the lower esophageal sphincter).

6. Do not smoke / vape / e-cigs, or use any such agents.

Hemorrhoids are dilated veins at the anus that can bulge out and bleed and cause issues with discomfort and hygiene. Rarely they can get thrombosed and swollen and quite painful. When hemorrhoids are severe, we perform surgery. When they are not very severe but are still problematic, we can often do less invasive techniques such as banding and Hemwell. Here are preliminary steps to treat or avoid hemorrhoids:

1. Avoid constipation and straining. 

   • Using devices such as toilet stools can improve rectal alignment during defecation.

   • Using safe laxatives such as Miralax or prunes to aim for smooth bowel movements.

2. Hygiene:

   • Be careful with excessive wiping. Gentle dabbing with some wipes can be less traumatic and irritating.

3. To treat hemorrhoid flare-ups:

   • Soak in the tub 1-3 times daily.

   • Preparation H can be helpful but do not use it for more than 1-2 weeks at a time as it can worsen hemorrhoids long-term.

We have other appointment options available for patients:

• Telehealth visit

• Concierge appointment (45 minute appointment)

• Home visit

To schedule one of these services, click here.