How Acid Reducers Can Help Treat Heartburn
What Types of Drugs Treat GERD? continued...
Antacids are often the first treatment for GERD. Many of these products combine aluminum, magnesium, or calcium with hydroxide or bicarbonate ions to neutralize stomach acid. Common brands include Alka-Seltzer, Maalox, Rolaids, and Tums. A similar product is the foaming agent, Gaviscon, which provides the stomach lining with a layer of foam protection against the acid.
Histamine 2 blockers (H2 blockers or H2-receptor antagonists) also treat GERD. Histamine is a compound that has wide effects in the body. In the stomach, it's involved in acid production. H2 blockers prevent histamine from landing on H2 receptors. That prevents the stomach from getting the message to make more acid. Therefore, less acid is produced, reducing heartburn. H2 blockers are used to treat both GERD and peptic ulcers. These products are available in a lower strength as OTC medications and at a higher strength as prescription drugs. Commonly used H2 blockers are:
- Famotidine (Pepcid as a prescription, Pepcid-AC as an OTC medication)
- Cimetidine (Tagamet and Tagamet-HB)
- Nizatidine (Axid and Axid AR)
Ranitidine (Zantacand Zantac 75)
Proton pump inhibitors (PPIs) block the enzyme in the stomach wall that makes acid. They work a little differently than the H2 blockers. Commonly used PPIs are:
- esomeprazole (Nexium)
- lansoprazole (Prevacid)
- pantoprazole (Protonix)
- rabeprazole (AcipHex)
omeprazole (several names, including Zegerid and Prilosec, which is available in both prescription and non-prescription strengths)
- dexlansoprazole (Dexilant)
The prokinetic class of drugs does not reduce acid production. Instead, prokinetics act to make the lower esophageal sphincter stronger. They also help the stomach process and move food more quickly. That reduces the likelihood that stomach contents move back up through the esophagus. However, because of their side effects, including sleepiness, emotional changes, and difficulty moving, prokinetics are used less often than the other kinds of medication. Metoclopramide (Reglan) is one example and it also makes muscles in the digestive tract work more effectively.
Are There Other Treatments for GERD?
Your doctor might recommend surgery to treat GERD if lifestyle changes and medications fail. Or surgery might be an option if you and your doctor feel it is preferable to years of taking medications.
The standard surgical treatment for GERD is called fundoplication. Nissen fundoplication surgery is used most often. In this surgery, part of the stomach is wrapped around the lower esophageal sphincter to make it stronger, stop reflux, and repair a hiatal hernia.
In addition to Nissen fundoplication surgery, there are various endoscopic methods to treat GERD. These include the Bard EndoCinch system and NDO Plicator. These techniques make the sphincter stronger by putting stitches into the sphincter.
What Are the Long-Term Effects of Untreated GERD?
If GERD is not treated, complications can result, including:
- Esophagitis -- inflammation in the esophagus
- Scarring that will make the esophagus more narrow, causing swallowing problems
- Worsening of asthma, chronic cough, or pulmonary fibrosis
- Barrett's esophagus, or abnormal cells in the esophageal lining; this condition is associated with esophageal cancer.