Lifestyle changes along with antacids, H2 blockers (for example, Pepcid), and proton pump inhibitors (for example, Prilosec)-either prescription or nonprescription-are usually tried first to treat symptoms that are likely caused by gastroesophageal reflux disease (GERD). Medications are used in the treatment of GERD to:

• Relieve symptoms (heartburn, sour taste, or pain).
• Allow the esophagus to heal.
• Prevent complications of GERD.

Nonprescription medications can be tried when symptoms are mild and infrequent. Stronger, prescription medications will probably be required if symptoms are more severe.

Depending on the severity of your symptoms, medications may need to be taken daily or only occasionally when GERD symptoms occur. Long-term-often lifelong-medication treatment is usually needed for GERD symptoms that are more severe, because symptoms tend to return when medication treatment is stopped.

Medication Choices

The following nonprescription and prescription medications may be used to treat GERD.

• Antacids (such as Gaviscon, Mylanta, Tums, or Rolaids) neutralize stomach acid and relieve heartburn. Making lifestyle changes and taking antacids are usually tried first when you have infrequent and mild symptoms.
• H2 blockers (acid reducers), such as nizatidine (Axid), famotidine (Pepcid), cimetidine (Tagamet), or ranitidine (Zantac), reduce the amount of acid in the stomach. They are available in both nonprescription and prescription strength. If nonprescription-strength H2 blockers don't relieve your symptoms, ask your doctor for prescription-strength medication. Taking H2 blockers and making lifestyle changes often help if you have more frequent GERD symptoms.
• Proton pump inhibitors, such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex), are prescription medications that reduce the amount of acid in the stomach. These medications often help when H2 blockers have failed to control symptoms of GERD. They are also used to treat severe GERD symptoms or inflammation of the esophagus (esophagitis). There is a nonprescription version of omeprazole (Prilosec OTC) available for the treatment of frequent heartburn. However, omeprazole for treatment of more serious ongoing conditions, including GERD and peptic ulcers, can only be prescribed by a doctor. Talk with your health professional to find out whether you should try this medication. Making lifestyle changes is still an important part of the treatment of GERD when using proton pump inhibitors.
• Prokinetic agents such as metoclopramide (Reglan) have several effects. They may make the valve between the esophagus and stomach (lower esophageal sphincter) close more tightly, which helps prevent stomach juices from getting into the esophagus. They may also help the stomach empty quicker. Prokinetic agents are sometimes combined with an acid reducer, but their use is limited by frequent, sometimes severe side effects.

What To Think About

Doctors usually try to choose a treatment that uses enough medication to control your symptoms but not so much that side effects become a serious problem.