Depending on how severe your GERD is, treatment may involve one or more of the following lifestyle changes, medications, or surgery.
Lifestyle ChangesAvoid reflux producing foods
These foods include:
- Fried foods
- Fatty foods
- Citrus fruits
- Tomato products
- Alcoholic beverages
- Citrus fruit drinks
If you smoke, stop.
Smoking inhibits the production of saliva. Saliva is one of your body's defenses against damage to the esophagus. Saliva also aids in neutralizing refluxed acid. Smoking also stimulates the production of stomach acid, and can weaken and relax the lower esophageal sphincter (LES).
Do not drink alcohol.
Alcohol increases the production of stomach acid, relaxes the lower esophageal sphincter, allowing stomach contents to reflux back up into the esophagus, and can make the esophagus more sensitive to stomach acid.
Lose weight if needed.
Obesity increases abdominal pressure, which can then push stomach contents up into the esophagus. Losing weight may help reduce acid reflux.
Eat small meals.
Large meals expand your stomach and increase upward pressure against the esophageal sphincter.
Wear loose-fitting clothes.
Clothing that fits tightly around the abdomen will squeeze the stomach, forcing food up against the LES, and cause food to reflux into the esophagus. Clothing that can cause problems include tight-fitting belts and slenderizing undergarments.
Avoid lying down for 3 hours after a meal.
Gravity helps to keep the stomach juices from backing up into the esophagus. Lying down with a full stomach makes reflux more likely.
Raise the head of your bed
With the head higher than the stomach, gravity helps reduce this pressure. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that's sturdy securely under the legs at the head of your bed to raise it 6 to 8 inches. A foam wedge under the mattress can also be used. You can also use a wedge pillow to elevate your shoulders and head.
MedicationsYour doctor may recommend over-the-counter antacids, which you can buy without a prescription, or medications that stop acid production or help the muscles that empty your stomach.
Antacids, such as Alka-Seltzer, Maalox, Mylanta, Tums, Rolaids, and Riopan are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Many brands on the market use different combinations of three basic salts--magnesium, calcium, and aluminum--with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, have side effects. Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects.
Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.
H2 blockers, such as Tagamet (cimetidine), Pepcid (famotidine), Axid (nizatidine), and Zantac (ranitidine), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have GERD symptoms. Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor. H2 blockers shouldn't be used for more than a few weeks at a time without evaluation by a doctor.
Proton pump inhibitors include Prilosec (omeprazole), Prevacid (lansoprazole), Protonix (pantoprazole), Aciphex (rabeprazole), and Nexium (esomeprazole), which are all available by prescription. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms in almost everyone who has GERD. Prilosec is available in an over-the-counter form (Prilosec OTC). Proton pump inhibitors shouldn't be used for more than a few weeks at a time without evaluation by a doctor.
For more information on these and other medications, please see Drugs A-Z.
Surgical OptionsFundoplication Surgery
Fundoplication is the standard surgical treatment for GERD. The purpose of the surgery is to reduce heartburn caused by acid reflux.
Radiofrequency Treatment for GERD
Radiofrequency treatment is a minimally invasive endoscopic procedure that is performed on an outpatient basis. It is used to treat gastroesophageal reflux disease (GERD).