What is the treatment for GERD?

The goals of treating gastroesophageal reflux disease are reducing reflux, relieving symptoms, and preventing damage to the esophagus. Your health care provider may recommend treating GERD in a stepwise fashion. For mild symptoms, simple lifestyle modifications may be enough. The next step is nonprescription antacids such as Maalox, Mylanta, Tums, or Rolaids. Other treatments include acid blockers and even surgery. In most cases, one or more of these treatments provide relief from GERD and prevent it from turning into a more serious disease.

I take nonprescription antacids when I have symptoms, but they don't seem to help.

Nonprescription antacids are only part of the treatment for GERD. They can work very well, but these antacids alone usually can't stop the symptoms. Your health care provider will probably recommend that you make changes in your lifestyle as well.

What kind of lifestyle changes are we talking about?

Any of the following may reduce your symptoms significantly:

• Don’t eat within 3 hours of bedtime. This allows your stomach to empty and acid production to decrease. If you don't eat, your body isn't making acid to digest the food.



• Similarly, don't lie down right after eating at any time of day.



• Elevate the head of your bed 6 inches with blocks, bricks, or books. Gravity helps prevent reflux. Just using more pillows won't help, because that actually increases the pressure on your stomach.



• Don’t eat large meals, especially before bed. Eating a lot of food at one time increases the amount of acid needed to digest it. Eat smaller, more frequent meals throughout the day.



• Avoid fatty or greasy foods, chocolate, caffeine, mints or mint-flavored foods, spicy foods, citrus, and tomatoes. These foods can irritate the already damaged lining of the esophagus.



• Avoid drinking alcohol without eating food, and definitely avoid drinking alcohol before bed. Alcohol increases the likelihood that acid from your stomach will back up.



• Stop smoking. Smoking weakens the lower esophageal sphincter and increases reflux.



• Lose excess weight. Overweight and obese people are much more likely to have bothersome reflux than people of healthy weight.



• Stand upright or sit up straight, maintain good posture. This helps food and acid pass through the stomach instead of backing up into the esophagus.



• Talk to your health care provider if you take over-the-counter pain relievers such as aspirin and ibuprofen (Advil, Motrin). These can aggravate reflux in some people.

Some of these changes are difficult for many people to make. Talk to your health care provider if you need some tips on losing weight or quitting smoking. Knowing that your symptoms will get better may keep you motivated.

Will these lifestyle changes stop the symptoms?

They may. If they don't, adding a nonprescription antacid or acid blocker can be helpful.