Brenda Khan
Gastroesophageal reflux disease (GERD) is a chronic condition that occurs when the contents of the stomach flow back into the esophagus, causing inflammation and damage. While GERD cannot go away on its own, it can be cured permanently with proper management. Doctors often recommend antacids for mild acid reflux and GERD inflammation, but these are not a good long-term solution as they can have side effects if taken too frequently. Diet plays a major role in controlling acid reflux symptoms and is the first line of therapy used for people with GERD. Lifestyle changes, such as avoiding certain types of food and beverages, losing weight, quitting smoking, and not eating before bed, can help improve symptoms. In some cases, medication or surgery may be required if lifestyle and dietary changes are not enough to manage the condition. While there is no definitive timeline for curing GERD with diet alone, research suggests that most people experience a reduction in symptoms over 6 months with dietary changes.
| Characteristics | Values |
|---|---|
| Cure for GERD | GERD can be cured permanently but it may take some trial and error and sticking to a treatment plan. |
| Treatment Plan | Doctors recommend lifestyle and dietary changes to see if they help keep acid from entering through the LES. |
| Medication | Proton pump inhibitors (PPIs) like omeprazole (Prilosec) are considered the mainstay of GERD treatment. PPIs are usually more effective than H2 receptor blockers. |
| Dietary Changes | Eating smaller meals, limiting spicy, fatty, or acidic foods, and not eating before bed could be enough to control symptoms without medication. |
| Lifestyle Changes | Losing weight, quitting smoking and drinking, wearing loose-fitting clothes, and sleeping with an elevated head can help manage symptoms. |
| Time to Cure | Research suggests that inflammation in the esophagitis from GERD can take up to 8 weeks to heal with successful lifestyle changes and medications. |
| Surgery | If home remedies and medications don't work, surgery can produce long-lasting results. |
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What You'll Learn
Dietary changes as a first-line treatment
Dietary changes are often recommended as a first-line treatment for GERD. This is because diet plays a major role in controlling acid reflux symptoms.
Foods that are high in fat, salt, or spice can cause the esophageal sphincter to relax, allowing food to push upward and cause acid reflux. As such, a person with GERD should limit their intake of spicy, fatty, or acidic foods, as well as coffee and alcohol. Eating smaller meals and avoiding meals close to bedtime could also help control symptoms. It is also recommended to avoid eating large meals within 3 hours of bedtime and to remain upright for a few minutes to allow food to digest before reclining.
In addition to dietary changes, other lifestyle changes can help treat GERD. This includes losing weight, quitting smoking, wearing loose-fitting clothes, and elevating the head while sleeping.
While dietary and lifestyle changes can be effective in treating GERD, they may not be sufficient for everyone. In some cases, medication or surgery may be required to manage the condition. It is important to consult a doctor or gastroenterologist to determine the most appropriate treatment plan for your individual needs.
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Natural home remedies
While medication is the most common form of GERD treatment, natural home remedies, coupled with lifestyle changes, can help alleviate mild GERD cases. Here are some natural home remedies that may help:
Baking Soda
Baking soda, or sodium bicarbonate, is a natural alkaline that helps neutralise excess stomach acid to ease heartburn.
Ginger
Ginger has been indicated by researchers as a promising treatment for heartburn.
Aloe Vera
Aloe vera juice or syrup has shown promise in combating heartburn.
Ripe Bananas
Ripe bananas are alkaline foods that may help counteract irritating stomach acid due to their high potassium content.
Turmeric/Curcumin
Combination products containing this curry spice have shown promise in fighting heartburn.
Deglycyrrhizinated (DGL) Licorice Root
Licorice may protect the oesophagus from damage by increasing mucus production. Special processing is required to remove a substance in the root that can cause dangerous side effects.
D-Limonene
D-Limonene, a substance found in citrus essential oil, has been shown to be effective at relieving GERD, albeit with limited research.
American Ginseng
Animal studies suggest that American ginseng may protect against oesophageal damage associated with GERD by reducing inflammation.
Marshmallow Root
Marshmallow root has shown promise in animal studies as a stomach protectant.
Slippery Elm
Combination products containing substances from the slippery elm tree have shown promise in treating heartburn.
Melatonin
Melatonin is a supplement used to aid sleep and has been suggested to help relieve heartburn. However, research is conflicting regarding its effectiveness in treating heartburn or other gastrointestinal symptoms.
It is important to consult a doctor or gastroenterologist before trying any natural remedies for GERD. While these remedies may help alleviate mild GERD cases, they may not be effective for everyone, and home remedies alone may not be sufficient to treat GERD.
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Over-the-counter medicines
While GERD is often treated through a combination of lifestyle changes and medication, over-the-counter (OTC) medicines can be effective in managing the condition. However, it is important to note that OTC treatments may not be sufficient for everyone and persistent symptoms should be evaluated by a doctor.
Several types of over-the-counter medications can help manage GERD symptoms by reducing the amount of acid in the stomach:
- Antacids neutralise stomach acid, providing fast relief from heartburn symptoms. Examples include Tums® and Rolaids®. While they are effective for occasional acid reflux, they are not recommended as a long-term solution as frequent use may lead to side effects and increased acid production in the stomach.
- Alginates are naturally occurring sugars derived from seaweed. They create a physical barrier between the acid and the oesophagus by floating on top of the stomach acid.
- Histamine receptor antagonists or H2 blockers reduce stomach acid production by blocking histamine, the chemical that signals the body to produce it. They can be taken more frequently than antacids but may not be effective in the long term as the body can adapt to their effects.
Proton pump inhibitors (PPIs) are prescription medications that are more effective than H2 blockers in suppressing acid production and promoting healing. They are typically prescribed for a course of 4-12 weeks. While PPIs are considered the mainstay of GERD treatment, they should be discussed with a doctor due to potential long-term risks and side effects.
In addition to these OTC medications, simple home remedies such as drinking non-fat milk or low-fat yoghurt, consuming ginger, and making dietary and lifestyle changes can also help alleviate GERD symptoms.
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Long-term medication and lifestyle changes
While there is currently no cure for GERD, the condition can be managed through long-term medication and lifestyle changes.
Long-term Medication
Proton pump inhibitors (PPIs) are the most common medication used to treat GERD. They work by blocking the mechanism that produces stomach acid, thereby lowering the acidity of digestive fluids and reducing reflux symptoms. PPIs are usually prescribed for 4–12 weeks. However, it is important to note that PPIs do not address anatomic deficiencies, which are often the root cause of abnormal reflux. There are also potential long-term risks and side effects associated with PPI use, so it is important to consult a doctor before starting this medication.
Other medications used to treat GERD include antacids and H2-receptor blockers (H2RAs). Antacids neutralise stomach acid and can provide fast relief for heartburn symptoms, but they are only a short-term solution. H2RAs have been shown to have reduced effectiveness as early as two weeks after beginning therapy, so they may also be more suitable for short-term use.
Lifestyle Changes
Lifestyle changes play a crucial role in managing GERD. These are some of the recommended changes:
- Dietary changes: Trigger foods that set off reflux differ from person to person but often include chocolate, coffee, fried foods, peppermint, spicy foods, and carbonated beverages. Eliminating some or all of these trigger foods can help reduce symptoms. Keeping a food diary can also help pinpoint which specific foods trigger symptoms.
- Avoid lying down after meals: It is recommended to avoid lying down for at least two hours after a meal or after drinking acidic or caffeinated beverages. This helps to prevent reflux and reduce symptoms.
- Weight loss: For obese individuals with GERD, weight loss can reduce pressure on the gastroesophageal junction, thereby reducing reflux.
- Smoking cessation: Smoking increases the production of stomach acid and reduces the function of the lower esophageal sphincter, which is responsible for keeping acid from entering the esophagus. Quitting smoking can help normalise esophageal sphincter pressure and increase salivary bicarbonate production, which neutralises acid.
- Head of bed elevation: Elevating the head of the bed can help reduce nighttime supine reflux and improve symptoms.
- Avoid late-evening meals: Eating late at night can increase supine acid exposure and worsen symptoms.
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Surgery as a last resort
While GERD can be cured permanently, it may take some trial and error and a commitment to a treatment plan. The first steps to managing GERD are typically medication and lifestyle adjustments, such as diet changes. Mild cases of GERD can be cured with natural home remedies and lifestyle changes. Dietary changes may include eating smaller meals, limiting spicy, fatty, or acidic foods, and not eating before bed. Lifestyle changes may include wearing loose-fitting clothes, losing weight, quitting smoking and drinking, and sitting upright or elevating your head. Over-the-counter medications such as antacids and alginates can also help neutralise the acid in the stomach and provide fast relief for heartburn symptoms.
If home remedies and medications don't relieve symptoms, a doctor may recommend prescription-strength H2 blockers or proton pump inhibitors (PPIs). These medications decrease the amount of acid in the stomach, allowing the oesophagus to heal. However, long-term use of PPIs may be associated with an increased risk of osteoporosis and fractures. In such cases, surgery may be recommended as a last resort. Surgery for GERD, also known as antireflux surgery, focuses on repairing or replacing the lower esophageal sphincter (LES) valve, which normally keeps acid from moving backward from the stomach. The most common type of surgical procedure is fundoplication, which tightens and reinforces the LES by wrapping a portion of the stomach around the bottom of the oesophagus. This procedure can be performed as open surgery or laparoscopic surgery. Laparoscopic surgery is less invasive and requires a shorter hospital stay and recovery time compared to open surgery. While surgery can produce long-lasting results, there are risks and complications, and it may not be suitable for everyone. Therefore, it is important to discuss the costs and potential risks with a doctor before deciding on surgery.
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Frequently asked questions
While there is no definitive answer, research suggests that it may take up to 8 weeks to heal GERD with successful lifestyle changes and medications. Doctors consider dietary changes a first-line treatment for GERD, and most people (81%) experience a reduction in GERD symptoms over 6 months.
Foods that are high in fat, salt, or spice can trigger heartburn and cause the esophageal sphincter to relax, allowing food to push upward and cause acid reflux. Coffee, alcohol, and large meals before bed should also be avoided.
In addition to dietary changes, you can try natural home remedies such as drinking a small amount of lemon juice mixed with warm water and honey, which has an alkalizing effect that neutralizes stomach acid. You can also try to lose weight, quit smoking and drinking, and wear loose-fitting clothes.
Over-the-counter medications such as antacids and alginates can help neutralize stomach acid and provide fast relief for heartburn symptoms. Proton pump inhibitors (PPIs) are usually prescribed for more severe cases of GERD and are considered the mainstay of GERD treatment.
If home remedies and medications don't relieve your symptoms, surgery is another option that can produce long-lasting results. A doctor may recommend surgery if other treatments are not sufficient to alleviate your symptoms.
