Treatment for gastroesophageal reflux disease (GERD) is aimed at reducing the abnormal backflow, or reflux, of stomach acid and juices into the esophagus; preventing injury to the lining of the esophagus or helping it to heal if injury has already occurred; preventing GERD from recurring; and preventing other conditions that might arise as complications of GERD.

Initial treatment

Treatment for people who have symptoms of gastroesophageal reflux disease (GERD) begins with making lifestyle changes and taking antacids, or nonprescription medicines that reduce or block acid. These include H2 blockers (for example, Pepcid) or a proton pump inhibitor (for example, Prilosec OTC). Frequent or severe GERD symptoms usually require stronger prescription medications along with lifestyle changes for successful treatment. When prescription medications are used to treat GERD symptoms:

• You may need to try different medications or combinations of medications before finding the one that best relieves your symptoms.
• The dose or frequency may need to be gradually increased until the most effective dose for you is found.
• Long-term-perhaps for the rest of your life-medication therapy is usually necessary to treat severe, persistent symptoms or complications of GERD.

Prescription medications for GERD include proton pump inhibitors (such as Nexium and Prilosec) and H2 blockers (such as Pepcid and Tagamet). Many of these medications are available in both prescription and nonprescription strength. For example, Prilosec OTC, the nonprescription version of omeprazole, is available for the treatment of GERD.

If symptoms are severe or have been present for a long time, your doctor may order an upper gastrointestinal endoscopy (esophagogastroduodenoscopy, or EGD). This test can help your doctor detect Barrett's esophagus, a change in the cells of the esophagus brought on by long-term exposure of the esophagus to stomach juices, or stricture, a narrowing of the esophagus. Barrett's esophagus increases the risk of cancer of the esophagus.

An important part of treating GERD is avoiding the things that stimulate your symptoms. These include foods such as spicy or fatty foods, chocolate, drinks that contain caffeine or alcohol, behaviors such as smoking, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) or other medications that increase symptoms.

Fundoplication surgery, which strengthens the valve between the stomach and the esophagus, may be used to treat GERD if lifestyle changes don't help or if treatment with medications does not relieve your symptoms.

Ongoing treatment

If medications and lifestyle changes control symptoms of gastroesophageal reflux disease (GERD), you will likely continue the same treatment. It is important that you continue to take medications as instructed by your health professional, since stopping therapy will often bring symptoms back.

Usually, basic treatments like lifestyle changes and taking antacids, or nonprescription medicines that reduce or block acid, are tried first before changing the treatment to prescription versions of these medicines. The nonprescription medicines include H2 blockers (for example, Pepcid) or a proton pump inhibitor (for example, Prilosec OTC). Each treatment should be tried for about 2 months before a new one is tried. The approach your doctor chooses will depend on the cause of your GERD, the symptoms you are having, and how severe they are. You and your doctor will also need to balance the effectiveness and safety of various treatments against the costs.