Self-Care at Home

Many people can relieve their symptoms by changing their habits and lifestyle. The following steps, if followed, may reduce your reflux 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. Gravity helps prevent reflux.
  
  
• Don't eat large meals. 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 tomato-based foods. These foods decrease the competence of the LES.
  
  
• Avoid drinking alcohol. 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 about taking over-the-counter pain relievers such as aspirin, ibuprofen (Advil, Motrin), or medicines for osteoporosis. These can aggravate reflux in some people.

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

Nonprescription (over-the-counter) remedies

These also may help relieve your symptoms. Check with your health care provider before trying any of these.

Antacids: These are effective when taken 1 hour after meals and at bedtime because they neutralize acid already present.

• Some familiar brand names of antacids are Gaviscon, Maalox, Mylanta, and Tums.
  
  
• Some are combined with a foaming agent. Foam in the stomach apparently helps prevent acid from backing up into the esophagus.
  
  
• These agents are safe to use every day over a few weeks, but if taken over a longer period can cause side effects:
  
  
  • Diarrhea
    
    
  • Impaired metabolism of calcium in the body
    
    
  • Build-up of magnesium in the body, which can damage the kidneys
    
    
• If you use these daily for more than 3 weeks, you should let your health care provider know.

Histamine-2 receptor blockers (H2-blockers): These prevent acid production.

• H2-blockers are effective only if taken at least 1 hour before meals because they don't affect acid that is already present.
  
  
• Common H2-blockers are cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), and nizatidine (Axid).

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GERD - Proton Pump Inhibitors

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Heartburn symptoms caused by GERD are usually relieved by drugs called proton pump inhibitors (Prilosec, Prevacid, Aciphex, Protonix, Nexium, Zegerid); however, proton pump inhibitors sometimes do not work well. If your symptoms were not relieved by treatment with proton pump inhibitors, can you please describe your GERD symptoms that did not improve? If you have other treatments that have been effective, please comment on those.

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