Treatment for GER & GERD

How do doctors treat GER and GERD?

Your doctor may recommend that you make lifestyle changes and take medicines to manage symptoms of gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD). In some cases, doctors may also recommend surgery.

Lifestyle changes

Lifestyle changes may reduce your symptoms. Your doctor may recommend

• losing weight if you’re overweight or have obesity
• elevating your head during sleep by placing a foam wedge or extra pillows under your head and upper back to incline your body and raise your head off your bed 6 to 8 inches
• quitting smoking, if you smoke
• changing your eating habits and diet

Over-the-counter and prescription medicines

You can buy many GERD medicines over the counter. However, if you have symptoms that will not go away with over-the-counter medicines, you should talk with your doctor. Your doctor may prescribe one or more medicines to treat GERD.

Antacids. Doctors may recommend antacids to relieve mild heartburn and other mild GER and GERD symptoms. Antacids are available over the counter. Antacids can help relieve mild symptoms. However, you shouldn’t use these medicines every day or for severe symptoms, except after discussing your antacid use with your doctor. These medicines can have side effects, such as diarrhea or constipation.

H2 blockers. H2 blockers lower the amount of acid your stomach makes. H2 blockers can help heal the esophagus, but not as well as proton pump inhibitors (PPIs) can. You can buy H2 blockers over the counter, or your doctor can prescribe one.

Proton pump inhibitors (PPIs). PPIs lower the amount of acid your stomach makes. PPIs are better at treating GERD symptoms than H2 blockers, and they can heal the esophageal lining in most people with GERD. You can buy PPIs over the counter, or your doctor can prescribe one. Doctors may prescribe PPIs for long-term GERD treatment.

PPIs are generally safe and effective. Side effects are uncommon and may include headache, diarrhea, and upset stomach. Research also suggests that taking PPIs may increase the chance of Clostridioides difficile (C. diff) infection. Experts are still studying the effects of taking PPIs for a long time or in high doses. Talk with your doctor about the risks and benefits of taking PPIs.

Your doctor may prescribe one or more medicines to treat GERD.

Other medicines. If antacids, H2 blockers, and PPIs don’t improve your symptoms, your doctor may recommend other medicines.

Surgery and other medical procedures

Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle changes and medicines, or if you wish to stop taking long-term GERD medicines to manage symptoms. You’re more likely to develop complications from surgery than from medicines.

Fundoplication. Fundoplication is the most common surgery for GERD. In most cases, it leads to long-term improvement of GERD symptoms. During the operation, a surgeon sews the top of your stomach around the end of your esophagus to add pressure to the lower esophageal sphincter and help prevent reflux.

Surgeons may perform fundoplication as laparoscopic or open surgery. In laparoscopic fundoplication, which is more common, surgeons make small cuts in the abdomen and insert special tools to perform the operation. Laparoscopic fundoplication leaves several small scars. In open fundoplication, surgeons make a larger cut in the abdomen.

Weight-loss surgery, also called metabolic and bariatric surgery. If you have GERD and obesity, your doctor may recommend weight-loss surgery, most often gastric bypass surgery. Weight-loss surgery can help you lose weight and reduce GERD symptoms.

Endoscopy. In a small number of cases, doctors may recommend procedures that use endoscopy to treat GERD. For endoscopy, doctors insert an endoscope—a small, flexible tube with a light and camera—through your mouth and into your esophagus. Doctors may use endoscopic procedures to sew the top of your stomach around the lower esophageal sphincter or to deliver radiofrequency energy to the sphincter. Doctors don’t use these procedures often.