In most cases, GERD is a clinical diagnosis. That is, the symptoms of GERD are often so classic that doctors usually can make a confident diagnosis based on them alone.
Diagnostic testing is usually done only when you fail to respond to therapy or if your doctor suspects that one of the more serious complications of GERD may have occurred. Tests often used in diagnosing GERD may include endoscopy, 24-hour pH monitoring, esophageal manometry, and barium swallow X-rays.
If you have GERD, the good news is that it is likely that you’ll be able to control your symptoms if you adopt appropriate lifestyle changes. These include:
- Weight loss
- Elevating the head of the bed
- Avoiding trigger foods
- Refraining from eating three hours or so before bedtime
- Avoiding tight-fitting clothing
In general, if you have only mild symptoms, your doctor will recommend such modifications and perhaps suggest an over-the-counter (OTC) medication. Antacids don't prevent or improve GERD, but they can be taken for occasional symptom relief. Commonly used antacids include Gaviscon, Maalox, Mylanta, Rolaids, and Tums.
Standard treatment of GERD generally involves prescription medication that decreases acid levels in the stomach and allows for healing of the stomach lining. The two most commonly used options, which also have OTC counterparts, are:
- Histamine-2 blockers (H2 blockers): H2 blockers help limit the production of stomach acid, so that stomach contents cause fewer symptoms when they reflux into the esophagus. H2 blockers begin working within an hour, becoming the most effective between one and three hours after taking a dose, and their effectiveness persists for up to 12 hours, They're more useful when they're taken regularly for a 2- to 4-week course of therapy. H2 blockers include Axid (nizatidine), Pepcid (famotidine), Tagamet (cimetidine), and Zantac (ranitidine).
- Proton pump inhibitors (PPIs): PPIs work by inhibiting the pump in gastric cells that produce stomach acid. They are the most potent acid inhibitors and are more effective than H2 blockers at eliminating symptoms and healing esophagitis. However, they tend to cause more adverse effects, so most doctors will try an H2 blocker first. The PPIs include Prevacid (pantoprazole), Nexium (esomeprazole), and Prilosec (omeprazole).
If your symptoms don't improve with lifestyle changes and prescription medications, your doctor may recommend surgery, though that is rare. The most common type is fundoplication, which is when the upper part of your stomach is wrapped around the LES in order to strengthen it and prevent reflux. Endoscopic techniques and implantation of a ring of magnetic beads called a LINX device, may also be considered.
If you are caring for someone with GERD, there are ways you can help your loved one deal with his or her symptoms at home. You can talk about and help her avoid foods that may trigger heartburn, encourage him to wear loose clothing, use medication as needed, encourage her to exercise, and keep his head elevated at night.
A Word From Verywell
GERD is a common gastrointestinal disorder that is usually reasonably mild, but it can cause serious complications if it's left untreated. If you have symptoms of GERD, you should work with your doctor to make sure you have the correct diagnosis and to make sure you receive a treatment regimen that will get rid of your problem before it worsens.
Fortunately, with appropriate lifestyle modifications and the medications available today, the large majority of people with GERD can be successfully treated before an annoying problem becomes a dangerous one.