Self-care

You can make many lifestyle changes to help treat your symptoms. Avoid foods that cause problems for you.

• Do not drink alcohol.
• Avoid drinks and foods that have caffeine, such as soda, coffee, tea, and chocolate.
• Avoid decaffeinated coffee. It also increases the level of acid in your stomach.
• Avoid high-acid fruits and vegetables, such as citrus fruits, pineapple, tomatoes, or tomato-based dishes (such as pizza, chili, and spaghetti).
• Avoid items with spearmint or peppermint.

Other lifestyle tips that may make your symptoms better are:

• Eat smaller meals, and eat more often.
• Lose weight, if you need to.
• If you smoke or chew tobacco, try to quit. Your doctor can help.
• Exercise, but not right after eating.
• Reduce your stress and watch for stressful, tense times. Stress can bother your reflux problem.
• Bend at the knees -- not your waist -- to pick things up.
• Avoid wearing clothes that put pressure on your waist or stomach.

Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. Take any of your medicines with plenty of water. When your doctor gives you new medicines, remember to ask if it will make your heartburn worse.

Try these tips before going to sleep:

• Do not skip meals or eat a large meal for dinner to make up for missed meals.
• Avoid late night snacks.
• Do not lie down right after you eat. Remain upright for 2 to 3 hours before you go to bed.
• Raise your bed 4 to 6 inches at the head of your bed, using blocks. You can also use a wedge support that raises the top half of your body when you are in bed. (Extra pillows that raise only your head may not help.)

Drug Treatment

Antacids can help neutralize your stomach acid. They do not help to treat the irritation in your esophagus. Common side effects of antacids include diarrhea or constipation. See also: Taking antacids

Other over-the-counter drugs and prescription drugs can treat GERD. They work more slowly than antacids but give you longer relief. Your doctor or nurse can tell you how to take these drugs. There are two different types of these drugs:

• H2 antagonists: famotidine (Pepcid), cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid)
• Proton pump inhibitors (PPI): omeprazole (Prilosec or Zegarid), esomeprazole (Nexium), lansoprazole (Prevacid), rabeprazole (AcipHex), and pantoprazole (Protonix)

Follow-up

You will have follow-up visits with your doctor to check your esophagus. You may also need to have dental check-ups. GERD can cause the enamel on your teeth to wear away.

When to Call the Doctor

Call your doctor or nurse if you have:

• Problems or pain with swallowing
• Choking
• A full feeling after eating a small meal portion
• Weight loss that cannot be explained
• Vomiting
• Loss of appetite
• Chest pain
• Bleeding, blood in your stools, or dark, tarry looking stools
• Hoarseness

Alternate Names

Peptic esophagitis - discharge; Reflux esophagitis - discharge; GERD - discharge; Heartburn - chronic - discharge

References

Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Medical Position Statement on the management of gastroesphageal reflux disease. Gastroenterology 2008; 135(4):1383-1391.

Richter JE, Friedenbert FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 43.

Wilson, J F. In the clinic. Gastroesophageal reflux disease. Ann Intern Med. 2008;149(3): ITC2-1-15; quiz ITC2-16

Update Date: 11/23/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.