If your doctor thinks that you have gastroesophageal reflux disease (GERD), he or she will prescribe medicine to treat your symptoms. There are 3 main groups of acid reflux medicines: Antacids, H2 blockers, and proton pump inhibitors (PPIs).
These drugs work by lowering the amount of acid your stomach makes. You can buy over-the-counter versions or get prescriptions from your doctor.
Over-the-Counter (OTC) Antacids
Over-the-counter (OTC) antacids are an effective treatment for mild heartburn, indigestion, and mild GERD symptoms. Whether you choose a pepsin inhibitor like TUMS or an H2-receptor antagonist like famotidine, these medications are safe to take without a doctor’s prescription and can help relieve acid reflux symptoms.
Antacids can also help reduce the amount of stomach acid you produce, says the University of Missouri Health Care gastroenterologist Yezaz Ghouri, MD. This can help alleviate the burning sensation and pain you feel in your chest, behind your breastbone, or upper abdomen, he says.
OTC antacids, such as bismuth subsalicylate, calcium carbonate, or magnesium hydroxide, neutralize the acid in your stomach and relieve heartburn and other symptoms. They are also available in chewable forms.
H2 blockers are medications that help reduce the amount of acid in your stomach. They are often used to treat heartburn or peptic ulcers.
These medicines work by binding to the histamine receptors on your stomach cells. This stops the histamine from triggering the stomach to produce acid, and it reduces the secretion of acid by 70 percent in 24 hours.
Medications in this class include cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid). They are usually taken with the first meal of the day, but may also be used with an antacid to control heartburn or acid reflux.
These drugs can cause some side effects, including rashes and dizziness. You should tell your doctor if you notice any of these symptoms.
Proton Pump Inhibitors (PPIs)
PPIs are a class of medications that work by blocking gastric acid secretion by irreversibly binding to and inhibiting the hydrogen-potassium ATPase pump that resides on the luminal surface of the parietal cell membrane.
They can help treat several conditions including gastroesophageal reflux disease (GERD), erosive esophagitis, and peptic ulcer disease. They are also used to prevent Helicobacter pylori infection and upper gastrointestinal bleeding.
However, long-term use of PPIs can lead to side effects such as calcium malabsorption and osteoporosis, B12 deficiency and anemia, and SIBO (Small Intestine Bacterial Overgrowth). These problems can make it difficult for patients to absorb their prescribed medicines properly.
In addition, they can increase the risk of cirrhosis-related complications such as hepatic encephalopathy, spontaneous bacterial peritonitis, and liver cancer. This is because PPIs suppress an enzyme called dimethylarginine dimethylaminohydrolase that helps relax blood vessels, reducing their ability to function correctly. This is why it is important to choose a PPI that is safe for you.
Surgery is a treatment option for people who have severe GERD that doesn’t respond to other medicines. It’s also used to treat those who have precancerous changes in the esophagus called Barrett’s esophagus.
For most people with GERD, medications help relieve symptoms and prevent complications. However, they don’t address the underlying cause of the reflux.
That’s why we often recommend minimally invasive surgery to help reduce acid reflux and improve your symptoms. For example, the surgeon wraps the top part of your stomach around your esophagus (called fundoplication) or puts a ring of magnetic beads around your esophagus to tighten your sphincter muscle and prevent reflux.
Before surgery, we’ll make sure you are ready for it by explaining what to expect and answering any questions you may have. We’ll also let you know what you can do before and after your surgery to help you feel better.