And they could get worse over time if left untreated. In these cases, you may need a prescription medication. If your symptoms aren’t very frequent or severe, OTC medications may work well. The OTC forms of H2 blockers and PPIs have lower dosage levels than the prescription versions.
GERD Symptoms and Diagnosis
days. Many people find their symptoms improve greatly if they change their lifestyle. Others may need to take medicines from time to time or long-term, depending on the results of a gastroscopy. There are some people for whom drug treatment is not suitable for one reason or another.
It might be difficult to figure out what to do when heartburn strikes. With such a variety of over-the-counter (OTC) treatments, miscellaneous herbal or other natural remedies, and prescription medications available, choosing the right treatment can be an adventure. PPIs include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), rabeprazole (Aciphex), and pantoprazole (Protonix). Many of these medications can now be found over-the-counter in certain doses, without a prescription.
Promotility agents. Drugs such as Reglan® speed up the digestive process. This decreases the amount of stomach acid that splashes back into the esophagus. Prescription-strength acid blockers.
Although generally well-tolerated, these medications might cause diarrhea, headache, nausea and vitamin B-12 deficiency. Chronic use might increase the risk of hip fracture. Surgery for GERD may involve a procedure to reinforce the lower esophageal sphincter called Nissen fundoplication. In this procedure, the surgeon wraps the top of the stomach around the lower esophagus. This reinforces the lower esophageal sphincter, making it less likely that acid will back up in the esophagus.
Try to avoid bending forward or wearing tight clothes as this can put extra pressure on your tummy. If you are having heartburn and want immediate relief, over the counter antacids (e.g., Maalox, Mylanta, Gaviscon, etc) are still the best. They act quickly to neutralize the acid and provide prompt relief.
There are a variety of heartburn medicines available over the counter to ease symptoms. If these don’t help enough, talk to your doctor about what else might help — in addition to lifestyle changes.
Check for other diseases
Sucralfate (Carafate) coats mucous membranes and sores to provide an additional protective barrier against stomach acid. They block the production of an enzyme needed to produce stomach acid. If self-care and treatment with nonprescription medication does not work, your health-care professional likely will prescribe one of a class of stronger antacids.
These medications are available in nonprescription and prescription strength and in tablet, capsule, liquid, or powder form. They should be taken as directed by your doctor.
You may also be asked to swallow a barium pill that can help diagnose a narrowing of the esophagus that may interfere with swallowing. Your doctor might be able to diagnose GERD based on a physical examination and history of your signs and symptoms. An endoscopy procedure involves inserting a long, flexible tube (endoscope) down your throat and into your esophagus. A tiny camera on the end of the endoscope lets your doctor examine your esophagus, stomach and the beginning of your small intestine (duodenum). Be sure to follow the directions on the label so you don’t overdose or overuse antacids.
If caught early, the condition can be treated and leave no signs of damage to your kidneys. Beyond the elevated infection risk, this study didn’t find a connection between PPIs and several other safety issues it examined that have been identified by earlier research. PPIs didn’t appear to cause fractures, kidney disease, dementia, cancer, heart disease, chronic obstructive pulmonary disease (COPD), hospitalizations, or premature death. Of all the potential safety concerns with PPIs, the risk of infections is one that doctors most consistently say changes how they prescribe the drugs. And, each year on PPIs was associated with up to a 0.5 percent higher risk of hip fractures for older adults taking the drugs in a different observational study.