Reflux Treatments

Understanding Your Options

How is GERD treated?

You may need to make changes to your lifestyle such as maintaining a healthy weight, quitting smoking, drinking less alcohol, or not eating foods that make GERD worse.

Treatment options for GERD may be different for each person.

Medicine
Taking medicine for GERD is the option most people choose first.
Endoscopic Treatments
Endoscopic treatments for GERD are newer and are still being studied, so less is known about how well they work or how safe they are.
In the next few pages, you can find more information about these types of treatment.

Medicine

Different medicines can help control problems caused by GERD.

  • Some relieve heartburn symptoms when they happen, and some help keep heartburn and other problems from happening.
  • Some medicines are taken only when needed and some are taken every day for a few weeks or months. Others must be taken every day for years.
  • Some medicines can be bought over the counter without a prescription, and others need a prescription. Some are available both over the counter and by prescription.
  • The three main types of medicines to treat GERD are antacids, H2RAs (histamine type 2 receptor antagonists), and PPIs (proton pump inhibitors).
Antacids
  • Antacids stop heartburn by neutralizing (weakening) the acid in your stomach.
  • They work quickly to treat mild GERD symptoms.
  • Antacids go by many names, such as Mylanta®, Rolaids®, or Tums®, and they are available without a prescription.
  • They are taken as pills or liquids.
  • You may need to continue taking antacids along with an H2RA or PPI to control symptoms.
  • H2RAs and PPIs work for a longer time than fast-acting antacids, but they do not start working as fast.
Histamine type 2 receptor antagonists (H2RAs)
  • H2RAs cause your stomach to produce less acid. Less acid in your stomach lowers your chance of getting heartburn.
  • All H2RAs are available both by prescription and over the counter.
  • They are taken as pills.
Names of H2RAs
Generic Name Brand Name
Famotidine Pepcid AC®; Calmicid®; Fluxid®; Mylanta AR®
Nizatidine Axid®; Axid AR®
Ranitidine Zantac®; Tritec®; Wal-Zan®
Cimetidine Tagamet®

Proton pump inhibitors (PPIs)

  • PPIs cause your stomach to make less acid, which helps prevent heartburn.
  • Many PPIs are prescription only, but some are available over the counter.
  • They are taken as pills.
Names of PPIs
Generic Name Brand Name
* Available over the counter.
Omeprazole Prilosec®*, Losec®*, Omesec®*
Omeprazole with sodium bicarbonate Zegerid®*
Lansoprazole Prevacid®*
Pantoprazole Protonix®
Rabeprazole Aciphex®
Esomeprazole Nexium®
Dexlansoprazole Dexilant®

What does research say about medicines for GERD?

  • PPIs work better than H2RAs to relieve heartburn and let the esophagus heal.
  • Most PPIs work equally as well as each other to prevent heartburn.
  • PPIs of prescription and over-the-counter strength seem to work equally well to prevent heartburn and let the esophagus heal.
  • Taking a small dose (amount) of a PPI may work as well as a larger dose in some cases.
  • Taking a PPI every day seems to work better than taking it only when you have symptoms.
  • PPIs may help cough but not hoarseness caused by GERD, although there is not enough research to know this for sure.
  • There is not enough research to know if PPIs help asthma caused by GERD.
  • Patients who are very overweight do not respond as well to medicine.

What are the side effects?

  • Antacids can have side effects such as diarrhea or constipation.
  • Possible side effects of H2RAs include headache, constipation, diarrhea, nausea, or vomiting.
  • PPIs can have side effects such as diarrhea, nausea, vomiting, pain in your abdomen (belly), upset stomach, and headache.
  • PPIs may increase your chance of getting an infection in your intestines (diarrhea) or lungs (pneumonia). They may also increase your chance of breaking a bone. These side effects are less common, however.
The U.S. Food and Drug Administration warned in 2009 that taking the PPI omeprazole (brand name Prilosec®) while also taking clopidogrel (brand name Plavix®) makes the clopidogrel less effective. Clopidogrel is a medicine that prevents heart attacks and strokes. It does this by keeping blood from clotting in the arteries of your heart or the blood vessels in your brain. These blood clots can lead to heart attack or stroke.