Once you have been diagnosed with gastroesophageal reflux disease, your gastroenterologist may initially recommend lifestyle modifications and over-the-counter medication. If your symptoms persist after a few weeks of following your treatment plan, prescription medication or surgery may be necessary.
Lifestyle and Dietary Changes
The first course of action for GERD treatment is making lifestyle and dietary changes. This includes:
- Losing weight if you are overweight
- Changing your diet (for example, avoid highly acidic food)
- Avoiding large meals
- Quitting smoking
- Not lying down immediately after a meal
- Elevating your head when lying down
Antacids (Tums, Alka-Seltzer, Gaviscon, etc.) – Often the first recommendation by your doctor, these medications naturally work to relieve heartburn and diminish some of the common symptoms of GERD. It is important to take antacids in moderation. Taking antacids frequently can increase acid reflux because antacids leave the stomach quickly.
H2 (histamine) blockers (such as Pepcid, Tagamet, Zantac) - Typically used to relieve heartburn that occurs in the evening. H2 blockers lower acid secretion and heal erosions in the esophagus in half of the patients who take them.
Proton pump inhibitors, or PPIs (Prilosec, Prevacid, Protonix, etc.) - The strongest medication for reducing stomach acids. PPIs block the three major pathways for acid production and are more effective than H2 blockers for suppressing acid production. They also heal erosions in the esophagus in many patients, including those with severe damage to the esophagus.
Prokinetic agents – These drugs enhance the activity of the smooth muscle in the gastrointestinal (GI) tract. They are not as effective as PPIs but your doctor may prescribe a prokinetic agent to be taken with a medication that suppresses acid production.
Baclofen – A medication used to reduce the relaxation of the lower esophageal sphincter and prevent stomach acid from backwashing into the esophagus.
Some patients will develop complications from long-term uncontrolled GERD. These complications may include strictures (narrowing in the esophagus), Barrett’s esophagus (a premalignant condition resulting from chronic GERD) and early esophageal cancers. At Cooper University Health Care, we offer specialized endoscopic procedures to diagnose and treat these complications with techniques such as dilation, stenting, endoscopic mucosal resection (EMR), endoscopic ultrasound (EUS), and radiofrequency ablation (RFA).
LINX® Reflux Management System – Cooper University Health Care recently became the first health system in South Jersey to implant the LINX device, a small, flexible band of titanium with magnetic beads that wrap around the base of the lower esophageal sphincter muscle to keep it closed tightly after drinking or eating. The magnetic beads used in this minimally invasive procedure allow food and drink to pass through yet are strong enough to prevent acid reflux and heartburn.
Nissen Fundoplication (laparoscopic anti-reflux surgery) – Cooper surgeons are among the most experienced at this minimally invasive procedure, which is the standard surgical procedure for GERD. in which the top of the stomach is wrapped around the lower esophagus. This procedure supports the lower esophageal sphincter muscle, allowing it to close tightly and prevent stomach acid from backwashing into the esophagus.
Transoral Incisionless Fundoplication – A minimally invasive, laparoscopic surgical procedure that uses an endoscope to repair and recreate the esophageal sphincter.
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