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.
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)