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. Wear loose-fitting clothing. This can reduce pressure on your abdomen. Avoid certain foods. Foods and ingredients that may cause heartburn include alcohol, caffeine, chocolate, fatty foods, fried foods, garlic, mint, citrus fruits, onions, tomatoes, and tomato-based sauces. Change the way you eat. Try eating smaller meals more often, eat slowly, and chew your food thoroughly. Don’t lie down right after eating. Wait two to three hours after eating before you lie down. Lying down with a full stomach puts increased pressure on your lower esophageal sphincter (LES) — the ring of muscle that separates your stomach from your esophagus. Raise the head of your bed. Try to make the head of your bed six to nine inches higher than the foot of your bed. You can do this by placing wood or cement blocks underneath the legs of your bed, or by putting a foam wedge under the upper half of your mattress. This kind of incline reduces pressure on your lower esophageal sphincter (LES) and makes it harder for your stomach’s contents to enter your esophagus. Quit smoking. Smoking makes it harder for your lower esophageal sphincter (LES) to function properly. Chewing gum or oral lozenges can increase saliva production, which may help clear stomach acid that has entered the esophagus. Address stress. Prior studies have shown an association between psychological stress and reflux esophagitis (inflammation of the esophagus from GERD), and the degree of inflammation correlated with the level of stress reported. Discuss chronic stress with your primary care doctor, and seek help through therapy or at-home techniques like mindfulness meditation. Widely used antacids include Mylanta (aluminum hydroxide and magnesium hydroxide), Rolaids (calcium carbonate and magnesium hydroxide), and Tums (calcium carbonate). H2 blockers These drugs work by reducing acid production. They don’t offer relief from symptoms as quickly as antacids, but they can work for up to 12 hours. They may also help heal your esophagus, although not as well as other options. Your doctor may recommend both an antacid and an H2 blocker to treat heartburn after meals. OTC options in this category include Tagamet (cimetidine) and Pepcid (famotidine). A stronger version of Pepcid (famotidine) is available with a prescription. Proton pump inhibitors (PPIs) These drugs greatly reduce acid production, offering relief from symptoms and helping your esophagus heal. OTC options in this category include Prilosec (omeprazole), Prevacid (lansoprazole), and Nexium (esomeprazole), and may be used for short-term treatment. Longer-term use should be guided by your doctor given the risks noted above. Prescription-strength versions of Prilosec (omeprazole), Prevacid (lansoprazole), and Nexium (esomeprazole), as well as Protonix (pantoprazole), Aciphex (rabeprazole), and Dexilant (dexlansoprazole) are available with a prescription. There are a couple of different surgical options for GERD, some examples include: Fundoplication In this procedure, a surgeon wraps the top of your stomach around your lower esophageal sphincter (LES) to tighten the muscle and prevent acid reflux. This is the most common type of surgery for GERD. It’s usually done as a minimally invasive laparoscopic procedure. The magnetic ring allows food to pass through into the stomach and keeps the area closed when no food is present. Talk to your doctor if you want to explore a complementary and integrative approach for your GERD, especially if you are taking it orally, and to discuss how to integrate it with your mainstream medication plan. Here’s some more information about complementary and integrative therapies for GERD, with varying supporting evidence. Herbal remedies Chamomile, licorice, and other herbs are sometimes used to relieve symptoms of GERD. Some herbal remedies, like medications, can have significant side effects and may interfere with certain medications, so it’s important to talk to your doctor before you start an herbal remedy. Relaxation techniques Measures like guided imagery and progressive muscle relaxation can reduce stress and anxiety, and may ease GERD symptoms or how you perceive them.
