General and Gastrointestinal Surgery

Non-Surgical Treatment Options for GERD

Basic principles for the treatment of GERD include:

  • Reducing intra-abdominal pressure, i.e., avoiding tight clothing, not eating immediately before going to bed and avoiding heavy lifting.
  • Eating small meals.
  • Assisting gravity by elevating the head of the bed at night, and avoiding bending over.
  • Increasing lower esophageal (LES) pressure by avoiding coffee, tea and cola which, because of their caffeine content, decrease LES pressure. Alcohol, cigarettes and nicotine also decrease LES pressure. Medications, such as nitrates, theophylline and calcium channel blockers, also decrease the LES pressure.
  • Using medications that may increase the LES pressure directly, such as Propulsid (cisapride) and Reglan (metoclopramide). 
    More about medication options
  • Improving gastric emptying by avoiding fatty foods and alcohol, which delay the emptying of the stomach.
  • Using medications that decrease acid production, e.g., the H2 blockers Axid (nizatidine), Tagamet (cimetidine), Pepcid (famotidine), and Zantac (ranitidine), as well as the proton pump inhibitors Prilosec (omeprazole) and Prevacid (lansoprazole).
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  • Avoiding foods that increase acid production or are very acidic.  For example, caffeine, alcohol, peppermint and nicotine all stimulate the production of acid.  Citrus fruits, onions and tomatoes all contain a lot of acid. Spicy foods should be avoided because they burn even if there is not a lot of acid in them.
  • Avoiding situations that increase acid production by the stomach, like stress.

More about medication options 

Reflux Disease