When lifestyle changes aren’t enough, here’s how doctors treat GERD.
If you have gastroesophageal reflux disease (GERD), you know that it’s more than just the occasional heartburn after indulging in some late-night pizza.
People who have GERD tend to experience heartburn or other acid reflux symptoms at least two to three times a week. This frequent acid reflux can cause other bothersome symptoms, like nausea, bad breath, and trouble swallowing. Learn more about the difference between heartburn and GERD.
What’s more, untreated acid reflux or GERD can lead to more serious complications, such as narrowing of the esophagus or even esophageal cancer.
“You don’t just want to accept this as part of your life,” says Roshini Raj, MD, a gastroenterologist at NYU Langone Health. “You want to make sure that you’re getting the correct diagnosis, evaluation, and the correct treatment.”
How Doctors Treat Acid Reflux and GERD
“In terms of acid reflux, it really depends on the individual, whether they can control it with lifestyle and diet changes versus medication,” says Dr. Raj.
“I always recommend trying to do the lifestyle and diet changes first, but in many instances it’s not enough, and seeing a doctor and talking about medication options is an important thing to do,” says Dr. Raj.
Medical Treatments for Acid Reflux and GERD
Medications for acid reflux tend to do one of two things: They either bind or neutralize the existing acid in the stomach, or they prevent the production of acid altogether.
Antacids. Antacids can provide fast, short-term relief for mild acid reflux by changing the existing stomach acid. They come in the form of chewable tablets, dissolving tablets, and liquid. Antacids are commonly found over the counter (OTC), like Rolaids or Tums.
“If those don’t work we go to H2 blockers or proton pump inhibitors (PPIs) which actually stop your stomach cells from producing as much acid,” says Dr. Raj.
H2 blockers. H2 blockers are available OTC or by prescription (you can get Pepcid as a prescription, and Pepcid-AC over the counter, for example). While H2 blockers don’t work as quickly as antacids, their effects do last longer.
Proton pump inhibitors (PPIs). Proton pump inhibitors, such as Nexium 24h or Prilosec, are often the next step if antacids or H2 blockers don’t work. They’re most often recommended to treat GERD, stomach and small intestine ulcers, and inflammation of the esophagus. These are also available OTC or by prescription.
“[H2 blockers and PPIs] have been shown to have some long-term side effects, especially for women,” says Dr Raj. “They may increase the risk of osteoporosis and you may be a little bit more prone to developing infections because you don’t have as much acid in your stomach.”
Surgical Treatments for Acid Reflux and GERD
In some cases, when medications aren’t enough or if a person doesn’t want to take medication, surgery is an option.
Surgery for GERD, or anti-reflux surgery, often involves a procedure called a fundoplication, which is when surgeons wrap a portion of the stomach around the bottom of the esophagus in an effort to strengthen the lower esophageal sphincter. “Endoscopic procedures are used to actually strengthen the esophageal sphincter, so that it’s harder for acid to come up from the stomach into the esophagus,” says Dr. Raj.
Surgery is often a last resort, and is recommended to people who have serious GERD complications, like inflammation of the esophagus.
Dr. Raj is a gastroenterologist and associate professor of medicine at NYU School of Medicine, and an attending physician at NYU Langone Medical Center.
00:00:00,000 --> 00:00:02,673
00:00:02,673 --> 00:00:06,929
In terms of acid reflux, it really depends
on the individual whether they can control
00:00:06,929 --> 00:00:09,910
it with lifestyle or
diet changes versus medication.
00:00:09,910 --> 00:00:13,690
I always recommend trying to do
the lifestyle and diet changes first, but
00:00:13,690 --> 00:00:15,810
in many instances, it's not enough.
00:00:15,810 --> 00:00:17,444
And seeing a doctor and
00:00:17,444 --> 00:00:22,444
talking about medication options
is an important thing thing to do.
00:00:22,444 --> 00:00:26,053
00:00:26,053 --> 00:00:27,974
Acid reflux just means literally,
00:00:27,974 --> 00:00:32,130
you have acid refluxing upwards from
your stomach into your esophagus.
00:00:32,130 --> 00:00:36,050
But GERD refers to the actual condition
where you're having that occurrence
00:00:36,050 --> 00:00:38,320
frequently, so at least twice a week and
00:00:38,320 --> 00:00:42,960
usually causing sometimes either symptoms
or some kind of damage to your esophagus.
00:00:42,960 --> 00:00:46,210
Medications for heartburn tend to
do one of two things, either they
00:00:46,210 --> 00:00:51,050
bind the acid that's already there or they
prevent your body from producing the acid.
00:00:51,050 --> 00:00:53,590
We usually start with the ones
that bind the acid first,
00:00:53,590 --> 00:00:57,690
these are the over-the-counter chewable
antacids that many people know.
00:00:57,690 --> 00:01:01,500
If those don't work, we go to H2
blockers or proton pump inhibitors
00:01:01,500 --> 00:01:05,600
which actually stop your stomach
cells from producing as much acid.
00:01:05,600 --> 00:01:09,310
The medications have been shown to
have some long-term side effects.
00:01:09,310 --> 00:01:13,190
Specifically for women, it may
increase the risk of osteoporosis and
00:01:13,190 --> 00:01:16,120
you may be a little bit more prone to
developing infections cuz you don't have
00:01:16,120 --> 00:01:17,690
as much acid in your stomach.
00:01:17,690 --> 00:01:20,780
In some cases of acid reflux,
medicines are not enough or
00:01:20,780 --> 00:01:24,980
the person doesn't wanna take medication,
so surgery is a potential option.
00:01:24,980 --> 00:01:27,550
Some of the endoscopic
procedures are used to actually
00:01:27,550 --> 00:01:30,560
strengthen the esophageal sphincter so
that it's harder for
00:01:30,560 --> 00:01:33,550
acid to come up from
the stomach into the esophagus.
00:01:33,550 --> 00:01:37,680
It's important to have your acid reflux
evaluated because in some cases,
00:01:37,680 --> 00:01:41,750
acid reflux can go on to more
serious conditions, stricturing or
00:01:41,750 --> 00:01:45,130
narrowing of the esophagus or
even esophageal cancer.
00:01:45,130 --> 00:01:47,890
So you don't wanna just sort of
accept this as part of your life.
00:01:47,890 --> 00:01:52,197
You want to make sure that you're getting
the correct diagnosis, evaluation,
00:01:52,197 --> 00:01:53,728
and the correct treatment.
00:01:53,728 --> 00:01:55,668
Over-The-Counter (OTC) Heartburn Treatment. U.S. Food and Drug Administration. (Accessed on July 2, 2018 at https://www.fda.gov/drugs/resourcesforyou/consumers/ucm511944.htm)
Patient education: Acid reflux (gastroesophageal reflux disease) in adults (Beyond the Basics). UpToDate. (Accessed on July 2, 2018 at https://www.uptodate.com/contents/acid-reflux-gastroesophageal-reflux-disease-in-adults-beyond-the-basics)