Treatment of Acid Reflux Disease

ID-100112444Gastroesophageal reflux disease (GERD) or acid reflux disease is a common health problem in most part of the world. The patient (himself/herself) starts treatment of acid reflux disease in most cases with use of over the counter (OTC) medications, which are used for relief from heartburn or acidity. If there is no relief or inadequate relief with the OTC acid reducing medications or there is recurrence, doctor should be consulted. The treatment (it is mostly medical and in severe cases it may be surgical) of acid reflux disease depends on severity of the symptoms and damage acid reflux has caused to the esophagus.

Medical treatment of acid reflux disease includes medications that reduce acid production in stomach, medications that neutralize stomach acid (antacids) and prokinetic drugs.

Medications that reduce/stop production of gastric acid:

This group includes proton pump inhibitors (such as omeprazole, lansoprazole, pantoprazole, rabeprazole etc.), H2-blockers (such as ranitidine, famotidine, cimetidine etc.). Proton pump inhibitors reduce (even stop) gastric hydrochloric acid production from stomach and help in acid reflux disease. H2-blockers also reduce gastric hydrochloric acid production, however H2-blockers are less effective in reducing gastric acid production in compare to proton pump inhibitors and as a result less effective.

Medications that neutralize stomach acid (antacids):

Antacids are very useful medications for immediate relief of symptoms of acid reflux disease such as heartburn. Antacids are available over the counter and very commonly used by many patients (self medication). Antacids work by increasing pH of stomach and reduce heartburn due to acid

Prokinetic drugs:

Prokinetic medications such as metoclopramide, domperidone etc. strengthen the lower esophageal sphincter (LES, which is responsible for prevention of backflow of gastric contents including acid from stomach to esophagus) and also cause rapid emptying of stomach, that is why known as gastric hurrying agents. By strengthening the lower esophageal sphincter and emptying the stomach contents fast prokinetic drugs reduce risk of backflow and exposure of esophagus from acid.

Surgery in treatment of GERD:

If medications are not helpful in GERD or in certain conditions (such as anatomical abnormality such as hiatal hernia or Barrett’s esophagus) surgery may be required. Some surgeries done for management of GERD or acid reflux disease include:

  • Surgery to reinforce the lower esophageal sphincter (Nissen fundoplication)
  • Surgery to strengthen the lower esophageal sphincter
  • Surgery to create a barrier preventing the backup of stomach acid
  • Surgical procedure to form scar tissue in the esophagus (Stretta procedure)

Image courtesy of marin /

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  • Scott May 17, 2013 10.07 pm

    My doctor prescribed Nexium for my acid reflux. I expected it to solve the problem, but it really didn’t.

    What did solve the problem was getting rid of a lot of acidic foods and beverages, especially coffee and colas.

    I would encourage people to see if that helps first before going to a doctor. But don’t wait too long because prolonged acid reflux can be physically damaging.

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