If you have been using nonprescription medicines to treat your symptoms for longer than 2 weeks, talk to your doctor. If you have gastroesophageal reflux disease (GERD), the stomach acid could be causing damage to your esophagus. Your doctor can help you find the right treatment. Making lifestyle changes is still an important part of the treatment of GERD when you are using medicine.

Antacids, H2 blockers, and proton pump inhibitors-either prescription or nonprescription-are usually tried first. Medicines can:

• Relieve symptoms (heartburn, sour taste, or pain).
• Allow the esophagus to heal.
• Prevent complications of GERD.

Medication choices

• Antacids, such as Mylanta and Tums. Antacids neutralize stomachacid and relieve heartburn. If you want to take medicine only when your symptoms bother you, antacids are a good choice.
• Acid reducers. These include:
  • H2 blockers, such as cimetidine (Tagamet) and famotidine(Pepcid). H2 blockers reduce the amount of acid in the stomach. Most are available in both nonprescription and prescription strength. If nonprescription H2 blockers don’t relieve your symptoms, talk to your doctor about trying prescription-strength medicine.
  • Proton pump inhibitors, such as lansoprazole (Prevacid) and omeprazole (Prilosec). Proton pump inhibitors (PPIs) reduce the amount of acid in the stomach. Some are available without a prescription.

Medicine may not prevent all of your GERD symptoms all the time. Even if you’re taking an acid reducer every day, you may still have heartburn from time to time. It’s okay to take antacids when you have heartburn like this. But if you feel like your daily medicine isn’t working to control your GERD symptoms, talk with your doctor. You may need to try a different medicine.

Be sure to keep taking medicines as instructed by your doctor, because stopping treatment will often bring symptoms back.

What to think about

• Doctors usually try to choose a treatment that uses enough medicine to control your symptoms but not so much that side effects become a serious problem.
• Besides medicines, surgery is the only other effective option to prevent GERD symptoms from coming back.

Surgery may be used to treat gastroesophageal reflux disease (GERD) symptoms that have not been well controlled by medicines.

Surgery may be an option when:

• Medicines don’t completely relieve symptoms, and the remaining symptoms are caused by reflux of stomachjuices.
• A person doesn’t want or, because of side effects, is not able to take medicines over an extended period of time to control GERD symptoms.
• Along with reflux, a person has symptoms such as asthma, hoarseness, or cough that do not adequately improve when treated with medicines.

The benefits of surgery need to be compared to the possible complications and new symptoms you may have after surgery. Surgery for GERD can cause problems with swallowing and burping. It can also cause extra gas in the digestive tract, which leads to bloating and passing gas(flatulence).

After surgery, you may need to have other procedures to fix these problems. Some people still have to take medicine to control their symptoms, even after surgery. And some people need to have surgery again.

Surgery choices

Fundoplication surgery is the most common surgery used to treat GERD. This surgery strengthens the valve between the esophagus and stomach(lower esophageal sphincter) to keep acid from backing up into the esophagus as easily. It relieves GERD symptoms and inflammation of the esophagus (esophagitis).

Other types of surgery for gastroesophageal reflux disease may include:

• Partial fundoplication. Partial fundoplication involves wrapping the stomach only partway around the esophagus. Full fundoplicationinvolves wrapping the stomach around the esophagus so that it completely encircles it. Most fundoplication surgery uses the full fundoplication method.
• Gastropexy. A gastropexy attaches the stomach to the diaphragm so that the stomach cannot move through the opening in the diaphragm into the chest. Gastropexy is done less often than fundoplication.