- H2 Blockers
- Proton Pump Inhibitors
- Bile Acid Binders
A Answers (6)
Mehmet Oz, MD, Cardiology, answeredMany people are able to decrease the impact or symptoms of gastroesophageal reflux disease (GERD) with lifestyle change, and a healthy nutrition and diet program. That said, sometimes you may need some additional help. Below are some of the medications your doctor may prescribe when helping you to reduce the discomfort and symptoms of GERD.
Medications are typically used to treat gastroesophageal reflux disease (GERD). Thanks to advances in medications, surgery is only needed in extreme cases - primarily if the patient is unwilling or unable to cope with the lifestyle changes necessary for management of reflux disease. There are both over-the-counter and prescription medicines that may help keep your stomach calm and even prevent flare-ups. They are:
- Antacids – Neutralize the acid present in the stomach, but these don't tend to last very long and they can actually cause the stomach to produce more acid to counteract low acidity.
- H2 blockers – Fight the acid-increasing mechanism of a substance called histamine. H2 blockers can reduce reflux in up to 50 percent of cases and are now available in both prescription (including generic versions) and over-the-counter (OTC) drugs.
- Proton Pump Inhibitors (PPIs) – Another set of acid-blocking agents that use a different mechanism from H2 blockers. They are often more effective than the latter and can even heal some of the damage acids may create.
- Prokinetic agents – Usually used in conjunction with one of the two prescription drugs above to enhance their effectiveness.
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.
- Antacids, such as Mylanta and Tums. Antacids neutralize stomach acid and relieve heartburn. If you want to take medicine only when your symptoms bother you, antacids are a good choice.
- 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.
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Ashley Koff, RD, Nutrition & Dietetics, answeredLots of medications are available today to help combat gastroesophageal reflux disease (GERD) -- a condition in which the liquid content of the stomach regurgitates (backs up, or refluxes) into the esophagus -- both over-the-counter and by prescription. But if we just turn to a drug, we may be missing something. The body's normal function is not to reflux (unless it is helping us in a moment of trauma to avoid choking or to get rid of something that it detects as bad for us). If you are having reflux routinely it means that the body is seriously trying to tell you something. It could be that you're producing too much stomach acid, but a lot of people actually have too little acid in the stomach. Too much food or eating too quickly? Food intolerances? Gravity working against you (lying down after eating)? As you can see, there are many things that could be factors, and medication addresses just one -- reducing the acid. So if it isn't your specific problem or your entire problem, you may not get the full fix.
Many over-the-counter medications treat GERD through different ways. There are antacids, which neutralize acid, and medications that coat the lining of the stomach. Newer medications help reduce or stop the production of acid, such as Zantac and Pepcid.
Should symptoms of gastroesophageal reflux disease (GERD) persist, over-the-counter antacids may decrease discomfort. Antacids, however, only work for a short time and for this reason, they have a limited role in treating reflux disease. Histamine H2 receptor antagonists (such as cimetidine, ranitidine, nizatidine, and famotidine) decrease acid production in the stomach. These medications work well for treating mild reflux symptoms and are quite safe, with few side effects. They are available over the counter at a reduced dose, or at a higher dose when given by prescription by your doctor.
Proton pump inhibitors (such as omeprazole, lansoprazole, dexlansoprazole, pantoprazole, esomeprazole, and rabeprazole) are all highly effective in treating reflux symptoms. These medications act by blocking the final step of acid production in the stomach and are typically taken once or twice daily prior to meals. For reflux symptoms that occur frequently, proton pump inhibitors are the most effective medical treatment. These medications typically work well, are safe and have few side effects. There may possibly be an increased risk of certain side effects with high doses or with long-term use (over one year), however. You should discuss this with your doctor if you require long-term use or high doses.
Prokinetics, or medications that stimulate muscle activity in the stomach and esophagus, are sometimes provided for the treatment of reflux disease. The only available drug in the market is metoclopramide, which has little benefit in the treatment of reflux disease and has some side effects, some of which can be serious.