Treatment Options for GERD: A Complete Guide

If you have gastroesophageal reflux disease (GERD), your doctor will probably recommend lifestyle changes and medication to treat your condition.

Lifestyle changes — including quitting smoking and losing weight, as well as changes in certain food-related habits — can be effective treatments for GERD.

Most people with GERD start with an over-the-counter (OTC) drug. If your symptoms don’t improve within a few weeks, your doctor may prescribe a prescription drug to take instead.

Here are some of the lifestyle strategies that can get GERD symptoms under control.

Quit Smoking

It also increases the risk of lung diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, which are often linked to GERD.

Maintain a Healthy Weight

Wear Loose-Fitting Clothing

Manage Stress

Various foods and ingredients can increase your risk of heartburn and GERD, while others may reduce it. Keep in mind, however, that not every person is affected by every food. If a food doesn’t bother you, there’s no need to avoid it.

Foods to Avoid

• Alcohol
• Caffeine
• Chocolate
• Fatty or fried foods
• Garlic
• Onion
• Citrus fruits
• Spicy foods
• Tomato sauces
• Vinegar
• Peppermint
• Carbonated beverages

Foods to Eat

• Bananas, melons, apples, and other non-citrus fruits
• Vegetables, eaten raw or plain
• Lean meats
• Oatmeal, rice, couscous, and whole-grain bread
• Olive, canola, sunflower, and other unsaturated vegetable oils

Other Dietary Tips

• Eat smaller meals more often.
• Eat slowly and chew your food thoroughly.
• Avoid eating three to four hours before bedtime.
• Wait two to three hours after eating before you lie down.
• Avoid vigorous exercise for two hours after eating.

If lifestyle remedies don’t help, you might need over-the-counter (OTC) or prescription medication to manage GERD symptoms.

Four kinds of medications can treat GERD:

• Antacids
• H2 blockers
• Proton pump inhibitors (PPIs)
• Potassium-competitive acid blockers (PCABs)

  [2]

  [8]

  
  

Antacids

Antacids are often the first type of drug doctors recommend to relieve heartburn and mild symptoms of GERD. They can offer quick relief by neutralizing stomach acid. But they’re not suitable to use daily or for severe symptoms. They can also lead to diarrhea or constipation.

Antacids are widely available over the counter and include:

• aluminum hydroxide and magnesium hydroxide (Mylanta)

  [9]

• calcium carbonate and magnesium hydroxide (Rolaids)

  [10]

• calcium carbonate (Tums)

  [11]

A pharmacist can advise you on how to choose an antacid; always let them know what other drugs you are taking in case there are interactions. If you’ve been using one of these remedies for two weeks and still have symptoms, speak with a doctor.

H2 Blockers

Your doctor may recommend an H2 blocker alongside an antacid to treat heartburn after meals.

Over-the-counter options include:

• cimetidine (Tagamet)

  [12]

• famotidine (Pepcid)

  [13]

Proton Pump Inhibitors (PPIs)

PPIs reduce acid production, offering relief from symptoms and helping your esophagus heal. They offer a long-term treatment for more severe symptoms.

The following PPIs are suitable for short-term treatment.

Over-the-counter options include:

• omeprazole (Prilosec)

  [14]

• lansoprazole (Prevacid)

  [15]

• esomeprazole (Nexium)

  [16]

Prescription-only options include:

• pantoprazole (Protonix)

  [17]

• rabeprazole (Aciphex)

  [18]

• dexlansoprazole (Dexilant)

  [19]

Research into the potential risks of high doses or long-term use of PPIs is ongoing.

If you find you need to take a PPI for longer than 14 days, talk to your doctor. You may be masking underlying issues that need to be addressed.

Potassium-Competitive Acid Blockers (PCABs)

Vonoprazan (Voquezna), a potassium-competitive acid blocker (PCAB), works by blocking stomach acids and has been shown in studies to significantly reduce heartburn episodes in patients with non-erosive GERD.

All procedures strive to tighten the lower esophageal sphincter by pulling the stomach down and then using it to wrap around the esophagus.

Fundoplication

Fundoplication is a minimally invasive procedure and the most common type of surgery for GERD.

Endoscopic Band Ligation

• Stretta: This procedure uses radiofrequency energy to tighten the muscles at the lower esophageal sphincter. It is the most common endoscopic procedure used to treat GERD in the United States.
• EsophyX: The EsophyX device is used in a procedure called transoral incisionless fundoplication (TIF). It creates a new valve by folding stomach tissue around the esophagus and inserting small plastic fasteners to keep it in place.

  [23]

• Lynx: Using a Lynx device, the surgeon wraps a ring of tiny magnetic titanium beads around the area where the stomach and esophagus join. The ring allows food to pass into the stomach but keeps the area closed when no food is present.

  [24]

Weight Loss Surgery

Herbal Remedies

• Chamomile
• Licorice
• Ginger

Ginger can help if nausea is one of your symptoms, while chamomile can calm irritation in the digestive tract and improve your sleep. Licorice coats the esophagus and stomach and protects against irritation.

Other, less common, herbal remedies include:

• Catnip
• Fennel
• Marshmallow root
• Papaya tea

• Crow dipper
• Poria mushroom
• Citrus unshiu peel

How Safe Are Herbal Remedies for GERD?

Herbal remedies, like medications, can have adverse effects and may interfere with other medications. Therefore, it’s essential to speak with your doctor before trying a herbal remedy.

“Herbal remedies lack FDA approval and oversight and have limited scientific data to support their overall efficacy,” says Carolyn Newberry, MD, a gastroenterologist at NewYork-Presbyterian Hospital / Weill Cornell Medical Center.

“While these remedies may be safe to try, you can’t tell how effective they will be, as the potency of such products is not regulated. Individual factors may also affect how useful the treatment is.”

“Licorice can have an effect on blood pressure and heart rhythms at high dosages and can interact with specific prescription medications including insulin, steroids, laxatives, and blood pressure medications,” warns Dr. Newberry.

Apple Cider Vinegar

Breathing Exercises

Acupuncture

The overall effectiveness of both treatments was similar, but those receiving acupuncture had better scores when it came to quality of life and anxiety than the other group.

The researchers believe acupuncture may improve a “heart-stomach” connection, which regulates gastrointestinal hormones. The improved hormonal balance, they suggest, would improve the function of the lower esophageal sphincter, inhibiting reflux.

• GERD treatments depend on the severity and frequency of symptoms, personal preference, and other factors.
• Lifestyle measures to reduce reflux include dietary choices and stress management.
• Fatty and spicy foods can worsen symptoms, while less acidic foods and whole-meal bread may be less likely to cause reflux.
• Medications range from OTC treatments for mild symptoms to long-term medications that may also help the esophagus heal.
• Surgery is an option if other treatments don’t help.
• Various complementary therapies are available, but more research is needed to determine if they are safe and effective.