How do I treat acid reflux?

Introduction

Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the backflow of stomach acid into the esophagus, leading to symptoms such as heartburn and regurgitation. Effective management of GERD aims to alleviate symptoms, prevent relapse, and avoid complications. Treatment strategies include lifestyle modifications, pharmacological interventions, and, in some cases, surgical procedures.

Key Insights

Lifestyle Modifications:
- Weight Loss and Smoking Cessation: Weight loss reduces esophageal acid exposure and reflux symptoms. Smoking cessation also alleviates reflux symptoms, particularly in normal-weight individuals.
- Meal Timing and Bed Elevation: Avoiding late evening meals and elevating the head of the bed can decrease nocturnal acid exposure and improve symptoms .
Pharmacological Interventions:
- Proton Pump Inhibitors (PPIs): PPIs are highly effective for short-term relief of heartburn and healing of erosive esophagitis. They are superior to histamine-2 receptor antagonists (H2RAs) and placebo in both empirical and endoscopy-negative cases .
- Histamine-2 Receptor Antagonists (H2RAs): H2RAs provide effective symptomatic relief, especially in milder cases of GERD, but are less effective over time compared to PPIs .
- Over-the-Counter (OTC) Medications: Antacids and low-dose H2RAs are commonly used for episodic or food-related symptoms, providing relief to a subset of patients.
Alternative and Complementary Treatments:
- Alginate-Based Compounds: Alginate formulations, such as Gaviscon, create a barrier to prevent acid reflux and have been shown to reduce heartburn and regurgitation effectively .
- Dietary Modifications: An anti-reflux diet and alkaline water can help manage symptoms. Specific dietary recommendations may vary based on cultural dietary habits .
- Other Therapies: Voice therapy, relaxation strategies, and certain herbal formulations may provide additional symptom relief, particularly for patients with vocal symptoms or globus sensation.
Surgical and Endoscopic Interventions:
- Antireflux Surgery: Procedures like Nissen fundoplication are options for patients with chronic, recalcitrant symptoms. Endoscopic techniques such as the Stretta and endocinch procedures offer less invasive alternatives with fewer complications but lower response rates.

Conclusion

Effective treatment of GERD involves a combination of lifestyle modifications, pharmacological interventions, and, in some cases, surgical or endoscopic procedures. Weight loss, smoking cessation, and dietary adjustments are foundational lifestyle changes. PPIs are the cornerstone of pharmacological treatment, offering superior symptom relief and healing compared to H2RAs and antacids. Alginate-based compounds and other complementary therapies can provide additional relief, especially for specific symptoms. For patients with persistent or severe symptoms, surgical and endoscopic options are available. Tailoring the treatment approach to the individual patient's needs and response to therapy is essential for optimal management of GERD.

How do I treat acid reflux?

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Lifestyle Intervention in Gastroesophageal Reflux Disease.

Weight loss and tobacco smoking cessation can reduce esophageal acid exposure and symptoms in GERD patients, while avoiding late evening meals and using bed elevation can help with nocturnal GERD.

Short-term treatment of gastroesophageal reflux disease

Acid suppressant therapy (PPI or H2RA) is more effective than placebo for short-term relief of heartburn in patients with persistent symptoms of GERD and those with endoscopy-negative reflux disease.

Treatment of Gastroesophageal Reflux Disease*

Proton pump inhibitors (PPIs) provide faster and more complete symptom relief and healing for erosive GERD compared to H2RAs, making them the mainstay of therapy for acid-related diseases.

Randomised clinical trial: relief of upper gastrointestinal symptoms by an acid pocket‐targeting alginate–antacid (Gaviscon Double Action) – a double‐blind, placebo‐controlled, pilot study in gastro‐oesophageal reflux disease

Gaviscon Double Action, an acid pocket-targeting alginate-antacid, may help relieve upper gastrointestinal symptoms in gastro-oesophageal reflux disease patients.

Alternatives to Acid Suppression Treatment for Laryngopharyngeal Reflux

An anti-reflux diet is recommended for all patients, and voice therapy may help with vocal symptoms, while prokinetics are insufficiently evidenced.

Review article: treatment for gastro‐oesophageal reflux disease – lifestyle advice and medication

Ingesting Japanese sweet cakes or rice cakes may provoke heartburn in GERD patients, and proton-pump inhibitors like rabeprazole offer more effective and less variable acid-suppressing treatment.

Alginate controls heartburn in patients with erosive and nonerosive reflux disease.

Faringel is a well-tolerated and effective treatment for reducing heartburn in patients with erosive and nonerosive reflux disease by modifying esophageal acid exposure time, number of acid refluxes, and their proximal migration.

Efficacy and Safety of a Natural Remedy for the Treatment of Gastroesophageal Reflux: A Double-Blinded Randomized-Controlled Study

The Mucosave formulation effectively reduces the frequency and intensity of symptoms associated with gastroesophageal reflux, improving health-related quality of life.

Management of gastroesophageal reflux disease.

Lifestyle modifications and pharmacologic agents are key to treating gastroesophageal reflux disease.

Therapeutic approaches to reflux disease, focusing on acid secretion.

Proton pump inhibitors (PPIs) and histamine H2 receptor antagonists (H2RAs) are effective noninvasive treatments for gastroesophageal reflux disease (GERD), with H2RAs potentially being useful for short-term control in high-grade cases.

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