Often, patients respond well to a combination of lifestyle changes and a medication regimen. Some patients do not find satisfactory relief from those methods and require surgical intervention. Other patients may choose surgery as an alternative to a lifetime of taking medication.
Dietary and lifestyle changes are the first step in treating GERD. Certain foods make the reflux worse. Suggestions to help alleviate symptoms include:. If lifestyle and dietary changes do not work, your doctor may prescribe certain medications. There are two categories of medicines for reflux.
One decreases the level of acid in your stomach, and one increases the level of motility movement in the upper gastrointestinal tract. Over-the-counter antacids are best for intermittent and relatively infrequent symptoms of reflux. When taken frequently, antacids may worsen the problem. They leave the stomach quickly, and your stomach actually increases acid production as a result.
Histamine 2 H2 blockers are drugs that help lower acid secretion. H2 blockers heal esophageal erosions in about 50 percent of patients. Proton pump inhibitors PPIs are drugs that block the three major pathways for acid production. PPIs suppress acid production much more effectively than H2 blockers.
PPIs heal erosive esophagitis in many patients, even those with severe esophageal damage. Prokinetic agents are drugs that enhance the activity of the smooth muscle of your gastrointestinal tract. Common OTC H2-blockers include:. OTC PPIs treat frequent heartburn occurs 2 or more days a week and are not intended for immediate relief of heartburn, as they may take one to four days for full effect. In contrast, prescription PPIs are used to treat conditions like gastroesophageal reflux disease GERD , stomach and small intestine ulcers, and inflammation of the esophagus.
PPIs work by reducing the amount of acid produced by the stomach. OTC PPIs are only intended for a day course of treatment and can be used up to three times per year. In this procedure, the surgeon wraps the top of the stomach around the lower esophagus after reducing the hiatal hernia, if present.
This reinforces the lower esophageal sphincter, making it less likely that acid will back up in the esophagus. The LINX device is an expandable ring of metal beads that keeps stomach acid from refluxing into the esophagus, but allows food to pass into the stomach.
Your doctor is likely to recommend that you first try lifestyle modifications and over-the-counter medications. If you don't experience relief within a few weeks, your doctor might recommend prescription medication or surgery. Prescription-strength treatments for GERD include:. GERD can usually be controlled with medication. But if medications don't help or you wish to avoid long-term medication use, your doctor might recommend:.
Transoral incisionless fundoplication TIF. This new procedure involves tightening the lower esophageal sphincter by creating a partial wrap around the lower esophagus using polypropylene fasteners. TIF is performed through the mouth with a device called an endoscope and requires no surgical incision. Its advantages include quick recovery time and high tolerance.
If you have a large hiatal hernia, TIF alone is not an option. However, it may be possible if TIF is combined with laparoscopic hiatal hernia repair. There is a problem with information submitted for this request. Subscribe for free and receive your in-depth guide to digestive health, plus the latest on health innovations and news.
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You will also receive emails from Mayo Clinic on the latest health news, research, and care. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. No alternative medicine therapies have been proved to treat GERD or reverse damage to the esophagus.
Some complementary and alternative therapies may provide some relief, when combined with your doctor's care. Talk to your doctor about what alternative GERD treatments may be safe for you. The options might include:. In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment anytime you don't understand something.
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