GERD, also known as gastroesophageal reflux disease, refers to the chronic symptoms that occur when stomach contents wash back into the esophagus. That happens when the sphincter muscle, which separates the esophagus from the stomach, relaxes or weakens. While GERD can cause uncomfortable symptoms like heartburn, regurgitation, and nausea, it is generally not serious. However, if left untreated, GERD / heartburn can lead to serious health problems like erosive esophagitis, Barrett’s esophagus, and cancer. Treatments available include:
1. Antacids
These provide relief when you experience the symptoms of GERD, such as heartburn. Acids are naturally present in the stomach to aid digestion. Therefore, whenever the stomach contents come back up into the esophagus, it causes heartburn since its lining is not built to withstand the low pH. The medications hence work by neutralizing stomach acid. There are different types available over the counter. Some contain magnesium, calcium, or aluminum and can cause diarrhea or constipation in some people. Antacids containing alginates help form a barrier between the stomach contents and esophageal lining, relieving heartburn and reflux.
2. H2 blockers
These refer to a category of medications used to relieve the symptoms of GERD and treat conditions such as gastritis, or peptic ulcers, that cause excess acid production in the stomach. The active ingredients in the H2 blockers travel to the receptors on stomach cells, which are responsible for releasing acids, inhibiting chemical reactions to prevent them from producing much acid. Reducing the amount of stomach acid relieves the pain and discomfort caused by GERD.
3. Proton Pump Inhibitors (PPIs)
Proton Pump Inhibitors otherwise known as PPIs are one of the most effective drugs for treating GERD. They work by blocking the production of stomach acid. That inhibition allows the affected esophageal sphincter time to heal and prevents further damage to the esophagus. PPIs are also effective in treating conditions like ulcers and erosive esophagitis.
4. Prokinetics
These are effective medications that help control acid reflux. They strengthen the lower esophageal sphincter (LES), improving digestion by increasing stomach emptying time. Faster emptying of stomach contents leaves no time for acid reflux. Although they are generally well tolerated, prokinetics can cause adverse side effects. Therefore, they are recommended for the most serious cases of GERD.
5. Fundoplication surgery
Fundoplication is among the most common surgeries to treat heartburn caused by GERD.
Doctors may not recommend this surgery until you try other treatments or lifestyle changes to control your GERD symptoms, and they fail. The surgery involves wrapping the upper stomach part around the lower portion of the esophagus then sewing it into place. It aims to strengthen the opening between the esophagus and stomach to prevent stomach acids from flowing back into the esophagus. Complications from fundoplication surgery are rare but can include bloating, belching, and difficulty swallowing. Some people also report diarrhea after surgery.
6. Lifestyle tips to manage GERD
However, before you seek treatment, it’s important to adjust your diet and lifestyle to help manage your symptoms by eating smaller meals more frequently throughout the day rather than three large meals, avoiding trigger foods that make your symptoms worse, maintain a healthy weight, avoid tight-fitting clothing that put pressure on your stomach, quit smoking, and limit your alcohol intake. You can also elevate the head of your bed by six to eight inches to discourage acid from flowing back into your esophagus while you sleep.
