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What is the treatment for GERD? PDF Print E-mail

Doctors recommend lifestyle and dietary changes for most people with GERD. Treatment aims at decreasing the amount of reflux or reducing damage to the lining of the esophagus from refluxed materials.

 

Avoiding foods and beverages that can weaken the LES is recommended. These foods include chocolate, peppermint, fatty foods, coffee, and alcoholic beverages. Foods and beverages that can irritate a damaged esophageal lining, such as citrus fruits and juices, tomato products, and pepper, should also be avoided.

 

Decreasing the size of portions at mealtime may also help control symptoms. Eating meals at least 2 to 3 hours before bedtime may lessen reflux by allowing the acid in the stomach to decrease and the stomach to empty partially. In addition, being overweight often worsens symptoms. Many overweight people find relief when they lose weight.

 

Cigarette smoking weakens the LES. Therefore, stopping smoking is important to reduce GERD symptoms. Cigarette smoking also interferes with normal forward peristaltic movement and predisposes patients to reflux. Nicotine decreases the body’s natural ability to buffer acid.

 

Elevating the head of the bed on 6-inch blocks or sleeping on a specially designed wedge (not propped up on pillows) reduces heartburn by allowing gravity to minimize reflux of stomach contents into the esophagus.

 

Antacids taken regularly can neutralize acid in the esophagus and stomach and stop heartburn. Many people find that nonprescription antacids provide temporary or partial relief. An antacid combined with a foaming agent such as alginic acid helps some people. These compounds are believed to form a foam barrier on top of the stomach that prevents acid reflux from occurring.

 

Long-term use of antacids, however, can result in side effects, including diarrhea, altered calcium metabolism (a change in the way the body breaks down and uses calcium), and buildup of magnesium in the body. Too much magnesium can be serious for patients with kidney disease. If antacids are needed for more than 3 weeks, a doctor should be consulted.

 

For chronic reflux and heartburn, the doctor may prescribe medications to reduce acid in the stomach. These medicines include H2 blockers, which inhibit acid secretion in the stomach. Currently, four H2 blockers are available: cimetidine, famotidine, nizatidine, and ranitidine. Another type of drug, the proton pump (or acid pump) inhibitor inhibits an enzyme (a protein in the acid-producing cells of the stomach) necessary for acid secretion. There are four acid pump inhibitors:  omeprazole, lansoprazole, pantoprazole sodium, and rabeprazole sodium.

 

Other medical approaches to therapy increase the strength of the LES and quicken emptying of stomach contents with motility drugs that act on the upper gastrointestinal (GI) tract. Metoclopramide is currently the only available medication.

 

Tips To Control Heartburn


1. Avoid foods and beverages that affect LES pressure or irritate the esophagus lining, including fried and fatty foods, peppermint, chocolate, alcohol, coffee, citrus fruit and juices, and tomato products.

2. Lose weight if overweight.

3. Stop smoking.

4. Elevate the head of the bed 6 inches.

5. Avoid lying down 2 to 3 hours after eating.

6. Take an antacid