Treatments and drugs
Treatment for heartburn and other signs and symptoms of GERD usually begins with over-the-counter medications that control acid. If you don’t experience relief within a few weeks, your doctor may recommend other treatments, including medications and surgery.
Initial treatments to control heartburn
Over-the-counter treatments that may help control heartburn include:
- Antacids that neutralize stomach acid. Antacids, such as Maalox, Mylanta, Gelusil, Gaviscon, Rolaids and Tums, may provide quick relief. But antacids alone won’t heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or constipation.
- Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac). H-2-receptor blockers don’t act as quickly as antacids do, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. Stronger versions of these medications are available in prescription form.
- Medications that block acid production and heal the esophagus. Proton pump inhibitors are stronger blockers of acid production than are H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec, Zegerid OTC).
Contact your doctor if you need to take these medications for longer than two to three weeks or your symptoms are not relieved.
If heartburn persists despite initial approaches, your doctor may recommend prescription-strength medications, such as:
- Prescription-strength H-2-receptor blockers. These include prescription-strength cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac).
- Prescription-strength proton pump inhibitors. Prescription-strength proton pump inhibitors include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant).These medications are generally well-tolerated, but long-term use may be associated with a slight increase in risk of bone fracture and vitamin B-12 deficiency.
- Medications to strengthen the lower esophageal sphincter. Baclofen may decrease the frequency of relaxations of the lower esophageal sphincter and therefore decrease gastroesophageal reflux. It has less of an effect than do proton pump inhibitors, but it might be used in severe reflux disease. Baclofen can be associated with significant side effects, most commonly fatigue or confusion.
GERD medications are sometimes combined to increase effectiveness.
Surgery and other procedures used if medications don’t help
Most GERD can be controlled through medications. In situations where medications aren’t helpful or you wish to avoid long-term medication use, your doctor may recommend more-invasive procedures, such as:
- Surgery to reinforce the lower esophageal sphincter (Nissen fundoplication). This surgery involves tightening the lower esophageal sphincter to prevent reflux by wrapping the very top of the stomach around the outside of the lower esophagus. Surgeons usually perform this surgery laparoscopically. In laparoscopic surgery, the surgeon makes three or four small incisions in the abdomen and inserts instruments, including a flexible tube with a tiny camera, through the incisions.
- Surgery to strengthen the lower esophageal sphincter (Linx). The Linx device is a ring of tiny magnetic titanium beads that is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the opening between the two closed to refluxing acid, but weak enough so that food can pass through it. It can be implanted using minimally invasive surgery methods. This newer device has been approved by the Food and Drug Administration and early studies with it appear promising.
Foods That Can Help You Fight Acid Reflux/Gerd And Some Medications Can Aggravate The Symptoms Of GERD
Most doctors will only prescribed you drugs to take and just tell you the foods to avoid. You are not told that you should eat naturally low-acid foods to help to control your heartburn symptoms.
Here are some suggested foods that you can incorporate into your diet to eat when you are trying to control acid reflux:
- Bananas and melons. Most fruits you want to avoid when you are suffering from heartburn because they have a high acid content. Bananas and melons do not and they are alkalizing (basic) food that make a great snack.
- Oatmeal. Oatmeal will not cause acid reflux. It contains a lot of healthy fiber and is very filling.
- Green vegetables. As mentioned before, many fruits and vegetables (such as tomatoes and onions) can make your heartburn worse. Green vegetables (such as asparagus, green beans, and broccoli) will not make your symptoms worse because they are low in acid content.
- Rice and couscous. These complex carbs will help to control your acid reflux.
- Lean poultry and meats. Baked, broiled, grilled or steamed chicken and turkey are good to eat while trying to control acid reflux. Make sure to remove the skin and do not fry. Ground beef and steak can also be okay to eat as long as they are lean.
- Fish. Fish that is grilled, poached or steamed are good to eat. Make sure not to fry fish or use fatty sauces.
- Potatoes. Potatoes and other root vegetables, except for onions, are good choices.
- Bread. Choose whole-grain bread. This is made with unprocessed grain and will contain natural fiber, vitamins, and other nutrients.
- Egg whites. They are low in acid content and high in protein. Make sure to remove the yolk which can cause heartburn symptoms.
- Fennel. Some studies have shown that fennel can help to improve your digestion. It is also low in acid content.
- Ginger. Ginger has long been used to treat upset stomach and heartburn.
- Parsley. Parsley has also been used for hundreds of years to treat upset stomach.
- Aloe vera. There has been evidence to show that aloe vera can help control heartburn but don’t take it in excess because it may have a laxative effect.
Pineapple, vinegar, walnuts are all acidifying foodsCheeses and yogurt are less so; however, the proteins require an acidic environment in the stomach to digest
When the correct foods are added to your diet, your symptoms of heartburn could decrease significantly. However, eating a low-acid diet may not always be enough. It is always a good idea to consult with your gastroenterologist.
1. “13 Foods That Fight Acid Reflux.” Health.com. Health Media Ventures. Web 18 Nov 2013.
2. “Foods That Fight Heartburn.” WebMD. November 12, 2013. Web 18 Nov 2013.
Utah Digestive Health Institute
Avoid: citrus fruits, cranberry juice, tomatoes and tomato-based foods, peppers, garlicand onions, spicy foods, most dairy products, caffeine, high-fat foods, deli meat, cheese, fatty cuts of meat, alcohol, chocolate, mayonnaise, butter and margarine, salad dressings, fried (greasy) foods, creamy sauces, carbonated beverages, black pepper.
Be Careful: berries, grapes, garlic, lean meats, yogurt, non-alcoholic beers and wines, sodas, reduced-fat cookies.
Enjoy: apples, bananas, broccoli, carrots, peas, green beans, chicken breast, fish, fat-free or low-fat cheeses, whole-grain bread and cereals, brown rice.
You can help curb your heartburn by choosing for a low-fat, high-fiber diet that’s heavy on whole grains, fruits and vegetables, and lean meats.
Whole-grain breads and cereals will help you feel full without irritating your stomach. For snacks, reach for graham crackers and pretzels instead of potato chips. Rice, particularly brown rice, is a good choice.
Choose lean cuts of meat, broiled, boiled or baked instead of fried or sautéed in oil or butter. In lunch meats, instead of grabbing the spicy salami, bologna or pastrami, opt for oven-baked turkey or chicken.
Egg whites are better than whole eggs. Feta and goat cheese are easier on the stomach than cheddar and other high-fat cheeses. Also good are cream cheese, sour cream and soy cheeses if they’re low-fat or fat-free. Eat your morning cereal with yogurt instead of milk to moisten it. Milk used to be a heartburn remedy, but actually increases stomach acid, causing rebound pain a short time later.
Fresh ginger acts as an anti-inflammatory and is an age-old remedy for stomach problems of all kinds. You can get your daily dose—2 to 4 grams (more than that can actually cause heartburn)—by steeping ginger in hot water to make tea, chewing a piece of ginger, or using ginger generously when you cook. Aloe vera juice, which you can find in health food stores, is also very soothing, but don’t overdo it. It’s also a laxative.
Additionally, if you suffer from heartburn, how you eat is almost as important as what you eat. That means slow it down, eat smaller portions and wait at least 3 hours before going to bed after mealtime.
If you experience occasional heartburn or frequent stomach problem such as gas or bloating, there are natural digestive aids that may also help. Healthy Choice Naturals Ultra-Zymes is one of the most comprehensive natural digestive aids available. It contains 18 enzymes that go to work fast to help you digest foods easily, and get relief from burning, bloating, gas and heartburn.
Natural Ways to Deal With GERD
1. Eliminate Foods that Fuel Inflammation
What researchers believe is that an overactive immune system results in the body being flooded with defense cells and hormones that damage tissues. Dietary and environmental toxins may build up in the body, turning the immune system on and keeping it highly reactive.
Foods that promote inflammation are:
- Corn and soybean oils
- Pasteurized dairy
- Refined carbohydrates
- Conventional meat
- Trans fats
2. Consume Foods that Fight Inflammation
To help ease inflammation in your body, adopt a diet rich in anti-inflammatory foods. Some inflammation-easing superstars include:
- Green leafy vegetables
- Wild-caught salmon
- Bone broth
Final Thoughts on the Potential New Cause of GERD
Adopting diet and lifestyle changes such as eating anti-inflammatory foods and quitting smoking can go a long way in easing GERD symptoms. You may want to also get tested to make sure an H. pylori infection isn’t triggering your symptoms.
Luckily, many people have success treating GERD through a healthier diet. Be sure to avoid inflammatory foods and adopt a diet rich in inflammation-quelling foods to see if natural treatments work for you. Although PPI drugs do work well for people with GERD, they do come with potential side effects, including an increased risk of heart disease and digestive infections.
WHAT FOODS THAT TRIGGER GERD?
Some Medications Can Aggravate The Symptoms Of GERD
Certain medications and dietary supplements can irritate the lining of your esophagus, causing heartburn pain, and others can increase the severity of gastroesophageal reflux disease (GERD). GERD is a chronic condition in which stomach acid flows back (refluxes) into your esophagus. This backwash of acid causes irritation and inflammation of the lining of your esophagus.
Medications and dietary supplements that can irritate your esophagus and cause heartburn pain include:
- Antibiotics, such as tetracycline
- Bisphosphonates taken orally, such as alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel)
- Iron supplements
- Pain relievers, such as ibuprofen (Advil, Motrin IB, others) and aspirin
- Potassium supplements
Medications and dietary supplements that can increase acid reflux and worsen GERD include:
- Anticholinergics, such as oxybutynin (Ditropan XL), prescribed for overactive bladder and irritable bowel syndrome
- Tricyclic antidepressants (amitriptyline, doxepin, others)
- Calcium channel blockers and nitrates used for high blood pressure and heart disease
- Narcotics (opioids), such as codeine, and those containing hydrocodone and acetaminophen (Lortab, Norco, Vicodin)
- Sedatives or tranquilizers, including benzodiazepines such as diazepam (Valium) and temazepam (Restoril)
- Theophylline (Elixophyllin, Theochron)
If you have GERD, ask your doctor if medications you take may affect your symptoms.
Question about Medications for Acid Reflux
You should also keep in mind that Prilosec and Prevacid don’t cure acid reflux. The best way to manage reflux over time is with lifestyle changes (avoiding the foods that trigger reflux, raising the head of your bed 6 inches, eating smaller meals, don’t eat 2-3 hours before bedtime) and medication.
I would start taking either the Prilosec or Prevacid but check with your doctor to be sure it’s safe to keep taking them every day on an ongoing basis (and give them time to work).
i have taken every medication there is to take,over the years,ranitidine is very good
about 3 inches higher to keep stomach contents at the lower part, and don’t constrict your stomach with tight belts or dresses. 5 weeks of Prilosec and Prevacid gave me a Fibromyalgia skin and upper body pain that made it hard for me to turn in bed, and one night I collapsed involuntarily while going to the bathroom -instant paralysis. I was able to get up, but I didn’t take anything after that incident. And, you guessed, I am a strong proponents of lifetime changes that eliminates GERD, and not an easy solution seeker to declare a chemical war in my digestive system. The pill only makes GERD a lifetime problem because it does eliminate the lifestyle causes of GERD. I have learned my lesson the hard way, but I have been GERD free for 8 years now through lifetime changes. The pleasure of eating is not risk free, and people like me have to settle for less eating pleasure or GERD. For me the choice was easy.
I need to take something for my AR and I was looking at both Prilosec and Prevacid OTC today. The directions say to take for 14 days and then stop and you can’t take it again for another 4 months. Does this work? Will it put a stop to my miserable AR?
Tried Prilosec, but had some side effects that I didn’t like. Decided to go the holistic route, and for now, has worked for me. I take 2 tsps. of Bragg’s apple-cider vinegar before eating and take 2 “Super Enzyems” from TwinLabs after eating. I am eating “geen-smart” and obviously not laying down after eating. More I can tell you, if you are interested?
75% with no side effects Dr. says can take rest of life should be no side effects. I also believe in lifetime changes practice same as straightguy has told you. One thing that really works for me is chewing fredent gum after a meal also does not stick to your teeth. Also take a tsp. of viniger in glass of warm water in morning don’t know if works or not but doesn’t hurt you.
Actually never felt better & Im an ole gal. All that good food also don’t forget to exercise almost everyone can take a walk. If over weight loose some.