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If you're unfamiliar with acid reflux or GERD, read about them, their symptoms, and their causes here. As a refresher, acid reflux is the "mild" version, while GERD is the chronic (and often severe) form of acid reflux. When doing research or consulting with a medical professional, medication frequently comes up. It's natural for people to wonder: Do I really need medication for acid reflux, or can I manage it own my own, or through other methods?
The impact of diet and lifestyle changes generally depends on what form of acid reflux you are seeking to overcome.
For most people, diet and lifestyle adjustments can significantly improve or even get rid of normal acid reflux. Common adjustments include:
• Eating smaller meals and avoiding large portion sizes.
• Losing weight, if recommended.
• Avoiding trigger foods like tomatoes, citrus, spicy foods, coffee, and more.
• Not lying down right after eating
• Sleeping on your left side
• Using a wedge pillow or elevating the head of your bed
• Quitting smoking or vaping
• Quitting regular drinking
• Not eating within 2-3 hours of going to sleep.
These changes can help prevent the LES from relaxing, and can also reduce pressure on the stomach. This lowers the chances that acid will move upward.
Focusing on diet and lifestyle changes is often enough to reduce or eliminate entirely normal acid reflux. In this case, medication may not be necessary at all.
While lifestyle and diet changes almost always help to relive symptoms, some (especially those with GERD) usually require more than just these changes.
Medications can play an important role when:
• Symptoms happen frequently, often twice a week or more
• Diet and lifestyle changes don't help enough
• Your esophagus has damage or inflammation
• You've been dealing with acid reflux for a long time
Medical professionals will often recommend or proscribe medication for cases like these. Common medications used for GERD and acid reflux include:
• Antacids: Antacids reduce the amount of acid in your stomach, which often helps to relieve reflux symptoms like heartburn, regurgitation, and indigestion. They can be purchased over-the-counter in liquid or chewable form, and are typically used for quick, short-term relief. Popular brands include Tums and Maalox.
• Protein pump inhibitors (PPIs): PPIs, similarly to antacids, aim to reduce the amount of stomach acid in your stomach. They do so by focusing on the glands in the lining of your stomach. PPIs are frequently used in the treatment process for GERD, as they can not only relieve symptoms, but also help treat damage to the esophagus caused by acid reflux. PPIs often require a prescription from a medical professional, especially for long-term use; popular types include omeprazole, pantoprazole, and esomeprazole.
• H2 blockers: H2 blockers reduce the amount of acid secreted by the glands in your stomach lining for up to 24 hours. They are often used for short-term relief for GERD and reflux, but gradually lose their effectiveness over time if used consistently. Some H2 blockers require a prescription, while others can be bought over-the-counter.
For GERD, PPIs are commonly recommend, as they are the strongest at reducing stomach acid and are also the best for longer-term use. Make sure to consult with a medical professional when figuring out your medication options.
This is a common question many people dealing with acid reflux and GERD ask, and is where a lot of confusion comes in.
Generally, PPIs and other reflux medications are very safe when used appropriately and under medical guidance. Short-term use of PPIs has limited side effects.
Long-term use is seen as more risky, and should be monitored by a medical professional. Possible side effects of long-term use can include impacts on bone health, vitamin deficiencies, worse nutrient absorption, and an imbalance in gut bacteria.
Usually, providers aim for PPIs to be taken temporarily, not permanently, and regularly evaluate the dose. When tapering off of PPIs, many people experience what is called acid rebound. While frustrating to deal with, this is seen as a natural part of the process as your stomach adjusts.
Almost everyone can get over their GERD or acid reflux through a combination of diet changes, lifestyle adjustments, and/or medications. However, for some rare cases, surgery may considered.
Surgery is usually reserved for:
• People with severe reflux that is not responding to medication.
• Those who develop physical complications like precancerous changes or esophageal narrowing.
• Those that are unable to tolerate long-term acid-suppressing drugs.
The most common procedure is called a fundoplication, in which the upper part of the stomach is wrapped around the lower esophagus. This is meant to strengthen the LES and prevent future reflux.
More recently, less invasive techniques have gained popularity. One of these is the LINX device, which is essentially a magnetic ring placed around the LES.
Surgical outcomes are generally good, but it is rare for a patient to get this far. Any decision about surgery should be made after a thorough evaluation by a medical professional.
Find out more about treating GERD and acid reflux here.
