Gastroesophageal Reflux Disease Treatments
Changes in your lifestyle is the first line of treatment for the symptoms of GERD. Lifestyle changes include:
- Avoiding food and beverages that cause GERD, including greasy and fatty foods, spicy foods, chocolate, tobacco, alcohol and caffeine
- Losing weight to reduce pressure on your abdomen
- Quitting smoking
- Wearing loose-fitting clothes
- Eating small, frequent meals instead of a few large meals
- Eating slowly and chewing thoroughly
- Avoiding lying down sooner than three hours after a meal
- Elevating the head of your bed six to eight inches
If lifestyle and dietary changes don't resolve your symptoms, your physician might advise using medication. There are a number of medications that can help alleviate the pain and discomfort of GERD, many of them over-the-counter medications, such as:
- Antacids: Drugs such as Alka-Seltzer®, Maalox®, Mylanta®, Rolaids® and Tums® may relieve mild symptoms of GERD.
- Foaming agents: These drugs, such as Gaviscon®, work by covering the stomach contents with foam to prevent reflux.
- H2 blockers: These medications offer short-term relief by decreasing acid production in the body. They include drugs such as Tagamet HB® (cimetidine), Pepcid AC® (famotidine), Axid AR® (nizatidine) and Zantac 75® (ranitidine) and are also available in prescription strength.
- Proton pump inhibitors: Drugs such as Prilosec® (omeprazole), Prevacid® (lansoprazole), Protonix® (pantoprazole) and Nexium® (esomeprazole) offer stronger treatment than H2 blockers.
- Prokinetics: Drugs such as Urecholine® (bethanechol) and Reglan® (metoclopramide) strengthen the lower esophageal sphincter and make the stomach empty its contents faster. Prokinetics have a number of side effects, however, that may limit their treatment value.
A combination of medications may be taken to help treat symptoms of GERD. For example, taking an antacid and an H2 blocker may help an individual by first neutralizing the acid in the stomach (the antacid) and then limiting additional acid production (the H2 blocker). Your physician will suggest the proper combination of medications, if this approach is used.
Talk to your physician if you are taking calcium channel blockers, theophylline or anticholinergic medications, which can worsen GERD symptoms.
In some cases, surgery may be considered as an alternative to long-term use of drugs or physical discomfort. Surgeries for GERD may include:
- Nissen fundoplication: In this procedure, the upper part of the stomach is wrapped around the lower esophageal sphincter to repair a hiatal hernia, prevent acid reflux and strengthen the sphincter itself. This surgery may be performed using a laparoscope (a thin, lighted tube inserted into the body through tiny incisions in the abdomen).
- Endoscopic techniques: These techniques use an endoscope to repair the faulty sphincter, including Bard® EndoCinch system, NDO Plicator and Stretta system.