The occasional bout of acid reflux, or heartburn, is fairly common. But when it graduates to gastroesophageal reflux disease (GERD)—reflux that involves a more significant amount of acid, occurs at least twice per week and interferes with daily life—the pain and inconvenience may be too much to “just deal with.”
Eating habits are often a trigger for the almost 30 million Americans living with GERD, but lifestyle and dietary changes alone may not be enough to deliver the relief you seek. These other options for improving GERD may help.
Manage Your Risk Factors
The list of risk factors for GERD is similar to that for acid reflux. Though some are out of your control, like pregnancy, hiatal hernia and scleroderma, you can work to have a positive effect on others:
- Medications: Several drugs, including NSAID pain relievers, birth control containing progesterone, antibiotics, sedatives and some prescriptions used to treat high blood pressure, anxiety, depression, osteoporosis and other health concerns can increase GERD symptoms. Tell your doctor about all medications you are on; he may be able to suggest a less-aggravating alternative. (Never stop a medication without your physician’s OK.)
- Alcohol: The lower esophageal sphincter (LES), a ring of muscle between the esophagus and stomach, helps prevent stomach acid from flowing into the esophagus. Alcohol relaxes this muscle, allowing acid to bubble up. Limit your intake to one drink (women) or two drinks (men) daily, or avoid drinking all together.
- Obesity: Researchers speculate that extra fat in the abdomen may increase pressure on the stomach and cause the LES to relax. Body fat may also release chemicals that slow the clearance of acid from the stomach. A study in The New England Journal of Medicine showed that losing even a few pounds can reduce your symptoms—an inspiring thing to remember as you take your first steps on your weight loss journey.
- Smoking: Smoking minimizes salvia production, which means that those who puff miss out on bicarbonate—an acid-neutralizing compound in the fluid. Plus, nicotine relaxes the LES and other smooth muscles, allowing stomach acid easier passage upward. Ask your physician about smoking cessation support.
- Asthma: Research hints that asthma attacks might relax the LES as well. You can’t cure yourself of asthma, of course, but you can be diligent about your management plan. (Tell your doctor if you notice that your GERD persists or worsens with asthma medication use, however.)
Ask About Medications for GERD
There are several drugs that can help improve your symptoms. Ask your doctor about:
- Antacids: These quick-relief, over-the-counter (OTC) drugs work by neutralizing stomach acid. Popular options include Maalox and Mylanta (aluminum hydroxide, magnesium hydroxide), and Rolaids and Tums (calcium carbonate).
- Histamine-2 (H2) blockers: Taken 30 minutes before eating, these medications (mostly available in both prescription and OTC forms) can help reduce the amount of acid being produced in your stomach. Axid (nizatidine), Pepcid (famotidine), Tagamet (cimetidine) and Zantac (ranitidine) are some examples.
- Promotility agents: These work by speeding up the process of emptying of food from the stomach. They are only available by prescription; Clopra, Maxolon and Reglan (metoclopramide) and Tegaserod (zelnorm) are some that may be recommended.
- Proton pump inhibitors: These drugs, which are taken about an hour before a meal, work by blocking acid production. Some OTC options are available, but prescription versions (which work to heal irritation in the esophagus, rather than just ease symptoms) may be recommended. Examples include Nexium (esomeprazole), Prevacid (lansoprazole) and Prilosec (omeprazole).
If you are already using an OTC medication and find that you reach for it more than twice a week, see your doctor: You may need one of these other options, or a reevaluation of your diagnosis.
Consider Complementary Medicine
These treatments haven’t been proven to treat GERD, but they may provide some relief:
- Acupuncture: A couple of small studies suggest that acupuncture may relieve symptoms by stimulating healthy gastrointestinal processes and inhibiting acid secretion in the stomach. You may also find acupuncture soothing, which may help reduce discomfort.
- Herbal remedies: Licorice, slippery elm, chamomile and marshmallow may reduce acid, but they can also interact with some medications, so it’s a good idea to check with your doctor or pharmacist before trying one of these herbs.
- Relaxation: Yoga, meditation and guided imagery (visualizing yourself in a pleasant scene, experiencing it with all your senses) can reduce stress and anxiety, helping to improve your body’s digestion process.
Surgery for GERD
Lifestyle modifications and medications are usually enough to help most people with GERD feel better, but surgery may be recommended for some people. Surgical procedures typically focus on reinforcing or strengthening the LES.