Treatment Options for GERD

How is GERD treated?

There are many ways to manage gastroesophageal reflux disease (GERD). Your doctor may recommend lifestyle changes, over-the-counter or prescription medications, or in some cases, surgery. The goal is to reduce acid reflux and improve your quality of life. 

Lifestyle changes for GERD

There are many ways to manage gastroesophageal reflux disease (GERD). Your doctor may recommend lifestyle changes, over-the-counter or prescription medications, or in some cases, surgery. The goal is to reduce acid reflux and improve your quality of life.

• Avoid trigger foods. Common foods that trigger GERD include spicy foods, acidic or citrus fruits, tomatoes (and tomato sauces), fatty foods, chocolate, mint, caffeine and alcohol. Keeping a food and symptom journal may help you identify your personal triggers.
• Eat smaller meals. Large meals can overfill your stomach and increase reflux. Eating smaller, more frequent meals can help.
• Eat slowly and chew thoroughly. Eating slowly reduces the amount of air you swallow, which can help minimize reflux symptoms.
• Limit liquids during meals. Drinking too much liquid while eating can increase stomach pressure.
• Maintain a healthy weight. Losing excess weight may relieve pressure on your stomach and reduce GERD symptoms.
• Raise the head of your bed. Elevate the head of your bed by 6 to 8 inches or use a wedge pillow to raise your upper body. Avoid stacking regular pillows, as they can worsen reflux by increasing abdominal pressure.
• Avoid lying down after meals. Finish eating at least 2 to 3 hours before bedtime to allow your stomach to empty.
• Wear loose-fitting clothes. Tight clothing and belts can put pressure on your abdomen and worsen symptoms.
• Quit smoking. Smoking weakens the lower esophageal sphincter (LES) and reduces saliva, which helps neutralize stomach acid.
• Drink less alcohol. Alcohol relaxes the LES and makes acid reflux more likely.
• Manage stress. Stress can worsen GERD symptoms. Try deep breathing, meditation or yoga. 
• Exercise regularly. Physical activity helps your digestive system function better.
• Track your symptoms. Keeping track of what makes your symptoms worse can help you avoid triggers. 

Over-the-counter GERD medications

For mild to moderate GERD symptoms, over-the-counter (OTC) medications can offer relief alongside lifestyle changes: 

• Antacids neutralize stomach acid for quick relief. Examples include Tums, Rolaids, Maalox, Mylanta and Gaviscon. 
• H2 blockers reduce acid production by blocking histamine. OTC options include famotidine (Pepcid) and cimetidine (Tagamet). 

If you're using OTC medications regularly or they’re not working, talk to your health care provider. You may need prescription treatment.

Prescription medications for GERD

If OTC options aren’t helping and your symptoms are moderate to severe, your doctor may prescribe medication. You should continue lifestyle changes even if you're on medication. 

Common prescription treatments include: 

• Proton pump inhibitors (PPIs): These reduce stomach acid production. They are often the first prescription choice for GERD. Examples include: 
  • Omeprazole (Prilosec) 
  • Esomeprazole (Nexium) 
  • Lansoprazole (Prevacid) 
  • Pantoprazole (Protonix) 
  • Rabeprazole (Aciphex) 
  Note: PPIs are typically taken 30 minutes before meals (usually breakfast or dinner). 
• Prescription-strength H2 blockers: These include higher doses of famotidine or cimetidine than OTC options.
• Prokinetic medications: These help strengthen the LES and move food through your stomach faster. Metoclopramide (Reglan) is one option. Erythromycin can also speed up stomach emptying but doesn’t affect the LES.
• Baclofen: This can help reduce how often the LES relaxes, preventing reflux.
• Alginate/antacid combinations: These form a protective barrier in your stomach to help prevent reflux.

Always follow your provider’s instructions for taking GERD medications. Take them at the same time every day, and don’t stop early—even if you feel better—unless your provider says it’s OK.

Let your provider know if you have side effects or concerns and keep up with follow-up appointments so they can track your progress. 

Surgical treatment for GERD

If medications and lifestyle changes don’t work, or if you want to avoid lifelong medication, surgery may be an option. GERD surgery is typically minimally invasive and often provides long-term relief. 

Before surgery, your provider will run tests to confirm that it’s safe and appropriate for you. 

Common surgical options include: 

• Fundoplication: The top of the stomach is wrapped around the esophagus to strengthen the LES. This is done laparoscopically through small abdominal incisions. A partial wrap may reduce side effects like difficulty swallowing. 
• Transoral incisionless fundoplication (TIF): A variation of fundoplication done through the mouth, avoiding abdominal incisions. It usually has a shorter recovery time. 
• LINX® reflux management system: A small ring of magnetic beads is placed around the LES to prevent acid reflux while still allowing food to pass. 
• Stretta procedure: A device delivers radiofrequency energy to the LES to help it function better. This is done through the mouth. 
• MUSE™ procedure: A stapler-like device is used through the mouth to tighten the area between the esophagus and stomach with internal folds. 

Talk with a gastroenterologist or GERD-specialized surgeon to learn which procedure may be right for you based on your symptoms and overall health. 

Preventing GERD complications

When GERD is treated properly, you’re not likely to have complications. So getting care for GERD symptoms and following your treatment plan is important.

Untreated, GERD could lead to:

• Esophagitis, including eosinophilic esophagitis where your esophagus is inflamed and painful. It may bleed and you could have trouble swallowing.
• Strictures, which are tight or narrow areas in your esophagus. They can make it hard for you to swallow food.
• Barrett’s esophagus, which is a change in the lining of the esophagus that may increase your risk of esophageal cancer.
• Breathing problems: If stomach acid in the throat gets into your airways, it can cause coughing and wheezing and make asthma worse.
• Dental problems: Stomach acid can wear away the enamel on your teeth, so your teeth are more sensitive and can get more cavities.
• Sleep problems: GERD symptoms can keep you awake at night, making you more tired the next day.

You can reduce your chances of having these complications by making lifestyle changes, taking the medication your provider recommends and having surgery if other treatments aren’t working. 

Get expert GERD care at Banner Health.

Our gastroenterologists can help you find relief and protect your long term health.