The Secrets of Managing GERD and Heartburn
Is it time to get serious about your GERD?
GERD Treatments: Medications continued...
“If you’re suffering with heartburn after drinking or eating a big spicy meal, a proton pump inhibitor is not going to help,” Cheskin says. “But an antacid will.” Just as antacids offer heartburn relief to people without GERD, they can help GERD sufferers who have occasional breakthrough symptoms.
Prokinetics. These prescription drugs -- like Reglan and Urecholine-- help speed up the emptying of the stomach. While they’re often mentioned alongside other GERD treatments, experts say that they’re rarely helpful. They might be of benefit to people who have GERD on top of another condition that’s slowing down their digestion. At the same time, prokinetics can have serious side effects.
Many potent drugs that were once only available by prescription -- like H2 blockers and the PPI Prilosec -- are now available over the counter. Experts say it’s fine for a person with occasional heartburn to use them, provided he or she follows the directions. Generally, they should never be used for more than two weeks.
GERD Treatments: Self-Care Tips
While drugs are often the main GERD treatment, there’s a lot you can do on your own. Here are some lifestyle tips for heartburn relief.
Avoid trigger foods. Changing your diet can yield big benefits. Classic GERD triggers include chocolate, coffee, alcohol, peppermint, citrus juices, and tomatoes. The exact food triggers vary from person to person.
The prospect of life without coffee or chocolate may seem terribly depressing. But you don’t necessarily have to give them up entirely. “It’s about how much of these foods you eat,” says Cheskin. “So you can probably still have a half cup of coffee without a problem. The trouble starts if you’re having the coffee after a spicy meal.”
Butschlick says she misses chocolate the most, but she still eats it on occasion. “I just try to keep it to a small piece,” she tells WebMD, “and I’m prepared with some Tums for afterward.”
Eat smaller meals. It’s not just what you eat, but how much. So avoid stuffing yourself. Instead of eating three big meals a day, try more frequent smaller meals.
Don’t eat before bed. Waring says you shouldn’t eat two to three hours before bed. Not eating gives your stomach time to empty before you lie down.
Loosen your belt. Tight belts or pants can aggravate your GERD symptoms. Wear looser clothing, especially at night.
Prop up the bed. When you stick blocks under the head of your bed and raise it 6 to 8 inches, gravity will prevent the acids in your stomach from flowing into the esophagus during the night. While this used to be common advice, not everyone can do it. “Sleeping on an elevated bed just isn’t very comfortable,” says Waring.
Lose weight. The heavier you are, the higher your risk of GERD. How much weight do you need to lose to control your symptoms? No one knows for sure, Rao says. But if you’re obese, aiming for a 10% weight loss is always a good idea.
Evaluate your other medications. Many common medications -- aspirin and other NSAID painkillers, along with some drugs for high blood pressure -- can make GERD worse. Talk to your doctor about possible alternatives that may not worsen your symptoms.
Stop smoking. Some experts believe that smoking may aggravate GERD symptoms. Add it to your list of good reasons to kick the habit.
Take your GERD medicine as prescribed. GERD symptoms may come and go, but the underlying condition remains. Once you’re feeling better, you may be tempted to stop your long-term medication. That’s not a good idea. “Even if you’re not having symptoms, the GERD could still be causing damage,” Cheskin says. “You may feel fine right up until the acid bores a hole in your esophagus.” Never stop taking your medication unless you’ve talked to your doctor.