Your doctor will work with you to identify the right treatment options for your symptoms. Treatments may include lifestyle changes, medication or surgery.
Your physician may recommend modifications to your lifestyle that may help you control acid reflux. These recommendations may include changes to your diet or your meal routine, as well as other behavior modifications that may decrease your symptoms.
Your doctor may prescribe medication to relieve symptoms and improve your daily life. These could include:
Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, and Riopan are usually the first drugs recommended to relieve heartburn and other mild gastroesophageal reflux disease (GERD) symptoms. Many brands on the market use different combinations of three basic salts – magnesium, calcium and aluminum—with hydroxide or bicarbonate ions to neutralize the acid in your stomach.
Foaming agents, such as Gaviscon, work by creating a raft of foam that floats above your stomach contents to prevent acid and gastric fluids from reaching the esophagus.
H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), decrease acid production. They are available in prescription strength and over-the-counter strength. These drugs provide short-term relief and are effective for about half of the people who have GERD symptoms.
Proton Pump Inhibitors
Proton pump inhibitors include medications such as omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex) esomeprazole (Nexium), dexlansoprazole (Dexilant) and are traditionally available by prescription. Many of these are now available in over the-counter strengths that do not require a prescription. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms and heal the esophageal lining in the majority of people suffering from GERD. These pumps provide a less acidic environment that promotes healing but they do not stop the reflux/regurgitation from occurring.
Your doctor is the best source for information about how to use medications for persistent heartburn or gastroesophageal reflux disease (GERD). Because drugs work in different ways, combinations of medications may help control symptoms.
Medical management of GERD is designed to control the symptoms and lessen the damage caused by stomach fluid splashing into the esophagus and airway. Medications and lifestyle adjustments do not fix the underlying issues that may be causing reflux. Most patients experience a rapid return of their previous symptoms when medications are discontinued.
Surgery is an option when medicine and lifestyle changes fail to successfully manage the symptoms and damage associated with persistent heartburn, also known as gastroesophageal reflux disease (GERD). The procedures utilized are designed to correct the mechanical/physical defect that allows reflux to occur. Some patients also choose surgery as an alternative to a lifetime of medication and lifestyle restrictions.
The LINX® Reflux Management System
The LINX Reflux Management System is an innovative minimally invasive procedure designed to improve how the lower esophageal sphincter (LES) functions. A surgeon places a small metal bracelet around the LES. By opening and closing, the bracelet helps let food pass through, while resisting regurgitation of acid and gastric contents from below.
George Gillian, MD is trained to perform the LINX procedure.
Patient Story: Aaron
Hear from Aaron, who received a LINX® Device to address his severe symptoms.
Nissen Fundoplication involves using the patients’ own tissue to repair the lower esophageal sphincter (LES). During this minimally invasive procedure, the hiatal hernia is repaired and the upper part of the stomach is wrapped around the LES to strengthen the sphincter, preventing acid reflux. This procedure is typically done as a laparoscopic surgery, which is conducted with small surgical instruments through tiny incisions in the abdomen. The small incisions greatly reduce the post-operative pain and allow for a much faster recovery. As the reflux is controlled, most patients no longer need medications for GERD.
Trans-oral Incisionless Fundoplication (TIF)
Trans-oral Incisionless Fundoplication (TIF) treats the underlying cause of GERD. TIF is a minimally invasive procedure that reconstructs the valve between the esophagus and the stomach to prevent reflux. A TIF trained physician uses an endoscopic device that enables them to reach the valve and stomach without the need for incisions. By using a non-invasive approach, complications are minimized, which leads to a reduced recovery time. Inova is one of the only providers in the region to offer this cutting–edge technology for GERD.
Physicians that are trained in the TIF procedure:
Watch an Ask the Expert lecture on GERD and TIF with Dr. Harnden and Dr. Lee: