The treatment of heartburn and other symptoms of GERD begins-the-counter drugs that normally control the acid. If you do not feel relief within a few weeks, your doctor may recommend other treatments such as drugs and surgery.
Initial treatment to control heartburn
Over-the-counter treatments that can help manage heartburn include:
Antacids, which neutralize stomach acid. Antacids such as Maalox, Mylanta, Gelusil, Rolaids and Tums, can provide quick relief. But antacids alone will not treat an inflamed stomach acid into the esophagus damaged. Overuse of some antacids can cause side effects such as diarrhea or constipation.
Medications to reduce acid production. Called H-2 blockers, these drugs cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 25, 75 Zantac, Zantac 150). H-2 blockers do not act as quickly as antacids, but they provide longer relief. Stronger versions of these drugs are available as prescription.
Medications that block acid production and treatment of esophagus. Inhibitors of the production of proton pump acid-blocking and allow time for damaged esophageal tissue to heal. Over-the-counter inhibitors proton pump are Prevacid (lansoprazole 24 HR) and omeprazole (Prilosec OTC).
Contact your doctor if you need to take these medications two or more times a week or if your symptoms are not relieved.
Prescription-strength medications
If heartburn persists despite initial approaches, your doctor may recommend prescription-strength medications, such as:
Prescription strength H 2-blockers. This is without the power of prescribing cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac).
The prescription-strength inhibitors proton pump. Prescription-strength proton pump inhibitors are esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (DEXILANT).
Rarely, these medications can cause bone loss and increase the risk of bone fractures. Your doctor may suggest that the calcium intake to reduce these risks.
These drugs can decrease the effectiveness of blood thinning medication, clopidogrel (Plavix). If you are prescribed an inhibitor of the proton pump and treated with Plavix, tell your doctor.
Medications to strengthen the lower esophageal sphincter. Called prokinetic agents, these drugs help your stomach empty more quickly and helps to tighten the valve between the stomach and esophagus. Side effects such as fatigue, depression, anxiety and other neurological problems that limit the usefulness of these drugs.
GERD drugs are often combined to increase efficiency.
Surgery and other procedures if the medication does not help
Most of GERD can be controlled with medication. In situations where drugs are not useful or if you want to avoid using long-term medication, your doctor may recommend more invasive procedures such as:
Surgery to strengthen the lower esophageal sphincter (Nissen). This surgery is to tighten the lower esophageal sphincter to prevent reflux by wrapping the upper stomach around the outside of the lower esophagus. Surgery may be open or laparoscopic. In open surgery, the surgeon makes an incision in the abdomen. 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 create a backup of stomach acid barrier (EndoCinch gastroplication endoluminal). This procedure uses an instrument, which is like a miniature sewing machine. It presents a pair of points (sutures) in the stomach near the weakened sphincter. Sewing material is then bonded together to create obstacles to prevent stomach acid from washing into the esophagus. Your doctor may recommend this procedure, if the drugs are not effective, or if you are not a Nissen fundoplication candidate. However, it is unclear who is best suited for this treatment, and research is ongoing.
The procedure is the scar tissue of the esophagus (Stretta procedure). This approach uses an electrode to heat tissue esophagus. The heat creates scar tissue and nerve damage, which correspond to acid reflux. The scar tissue that forms as the esophagus has improved to help strengthen the muscles. Your doctor may recommend this procedure, if the drugs are not effective, or if you are not a Nissen fundoplication candidate. However, it is unclear who is best suited for this treatment, and research is ongoing.
Initial treatment to control heartburn
Over-the-counter treatments that can help manage heartburn include:
Antacids, which neutralize stomach acid. Antacids such as Maalox, Mylanta, Gelusil, Rolaids and Tums, can provide quick relief. But antacids alone will not treat an inflamed stomach acid into the esophagus damaged. Overuse of some antacids can cause side effects such as diarrhea or constipation.
Medications to reduce acid production. Called H-2 blockers, these drugs cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 25, 75 Zantac, Zantac 150). H-2 blockers do not act as quickly as antacids, but they provide longer relief. Stronger versions of these drugs are available as prescription.
Medications that block acid production and treatment of esophagus. Inhibitors of the production of proton pump acid-blocking and allow time for damaged esophageal tissue to heal. Over-the-counter inhibitors proton pump are Prevacid (lansoprazole 24 HR) and omeprazole (Prilosec OTC).
Contact your doctor if you need to take these medications two or more times a week or if your symptoms are not relieved.
Prescription-strength medications
If heartburn persists despite initial approaches, your doctor may recommend prescription-strength medications, such as:
Prescription strength H 2-blockers. This is without the power of prescribing cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac).
The prescription-strength inhibitors proton pump. Prescription-strength proton pump inhibitors are esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (DEXILANT).
Rarely, these medications can cause bone loss and increase the risk of bone fractures. Your doctor may suggest that the calcium intake to reduce these risks.
These drugs can decrease the effectiveness of blood thinning medication, clopidogrel (Plavix). If you are prescribed an inhibitor of the proton pump and treated with Plavix, tell your doctor.
Medications to strengthen the lower esophageal sphincter. Called prokinetic agents, these drugs help your stomach empty more quickly and helps to tighten the valve between the stomach and esophagus. Side effects such as fatigue, depression, anxiety and other neurological problems that limit the usefulness of these drugs.
GERD drugs are often combined to increase efficiency.
Surgery and other procedures if the medication does not help
Most of GERD can be controlled with medication. In situations where drugs are not useful or if you want to avoid using long-term medication, your doctor may recommend more invasive procedures such as:
Surgery to strengthen the lower esophageal sphincter (Nissen). This surgery is to tighten the lower esophageal sphincter to prevent reflux by wrapping the upper stomach around the outside of the lower esophagus. Surgery may be open or laparoscopic. In open surgery, the surgeon makes an incision in the abdomen. 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 create a backup of stomach acid barrier (EndoCinch gastroplication endoluminal). This procedure uses an instrument, which is like a miniature sewing machine. It presents a pair of points (sutures) in the stomach near the weakened sphincter. Sewing material is then bonded together to create obstacles to prevent stomach acid from washing into the esophagus. Your doctor may recommend this procedure, if the drugs are not effective, or if you are not a Nissen fundoplication candidate. However, it is unclear who is best suited for this treatment, and research is ongoing.
The procedure is the scar tissue of the esophagus (Stretta procedure). This approach uses an electrode to heat tissue esophagus. The heat creates scar tissue and nerve damage, which correspond to acid reflux. The scar tissue that forms as the esophagus has improved to help strengthen the muscles. Your doctor may recommend this procedure, if the drugs are not effective, or if you are not a Nissen fundoplication candidate. However, it is unclear who is best suited for this treatment, and research is ongoing.
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