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Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein. You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Get the Compare Your Your Quiz Your Summary GERD (gastroesophageal reflux disease) is the flow of stomach juices back up into the esophagus. This backup, called reflux, happens if the valve between the lower end of the esophagus and the stomach doesn't close tightly enough. The most common symptom is heartburn, an uncomfortable feeling of burning or pain just behind the breastbone. Another common symptom is a sour taste in the mouth. People with very bad, untreated GERD symptoms may get esophagitis (say "ee-saw-fuh-JY-tus"). This means that the esophagus is inflamed and irritated from the constant contact with stomach acids and digestive juices. GERD also can cause Barrett's esophagus, which is a change in the cells lining the esophagus. In rare cases, it may lead to cancer. Treatment usually starts with lifestyle changes—such as quitting smoking and losing weight—and with medicines that you can buy without a prescription. These medicines reduce or block stomach acid. They include H2 blockers (such as Pepcid) and proton pump inhibitors (such as Prevacid and Prilosec). Talk to your doctor if over-the-counter medicines aren't controlling your symptoms. In most cases, he or she can prescribe other medicine to help control your symptoms. The most common surgery for GERD is called fundoplication surgery. It involves wrapping part of the stomach around the esophagus to strengthen it. If you have a hiatal hernia, it also will be fixed. This surgery is often done laparoscopically. Instead of making a large cut (incision) in the belly, the doctor puts a lighted tube, or scope, and surgical tools into small cuts in your belly. This allows the doctor to see into your belly to do the surgery. You may decide to have surgery if: Lifestyle changes and antacids are usually tried first to treat pregnant women who have GERD. Some nonprescription antacids are safe to use during pregnancy to treat symptoms. Antacids that contain sodium bicarbonate can cause fluid to build up, so they should not be taken by pregnant women. And do not use antacids that have magnesium trisilicate, because they may not be safe for your baby. But it is okay to use antacids that contain calcium carbonate (such as Tums). Be careful when you take over-the-counter antacid medicines. Many of these medicines have aspirin in them. While you are pregnant, do not take aspirin or medicines that contain aspirin unless your doctor says it is okay. If lifestyle changes and antacids don't help control your symptoms, talk to your doctor about using other medicines. Medicines relieve GERD symptoms for most people. Proton pump inhibitors may work better than H2 blockers depending on your GERD symptoms, but you may need to try more than one medicine to find one that works well for you. And you may still sometimes need to take an antacid (such as Mylanta or Tums) to stop heartburn. No matter which medicines you try, making lifestyle changes is still an important part of your treatment. If your GERD symptoms are very bad, you will probably need to take medicines every day. That's because symptoms tend to return if you stop taking medicine. The medicines for GERD are generally safe, but each has different side effects. Surgery relieves symptoms for most people, but not for everyone. Laparoscopic surgery improves GERD symptoms in 8 out of 10 people. And surgery heals the damage done by GERD to the esophagus (esophagitis) in about 9 out of 10 people.footnote 1 All major surgery has risks, including a risk of breathing problems caused by the anesthesia. There also is a risk of bleeding, infection, and pain. Surgery for GERD can involve other problems: Your doctor might recommend surgery if: Compare What is usually involved? What are the benefits? What are the risks and side effects? These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I was having tests for another health problem when my doctor discovered I have a hiatal hernia. She told me the hiatal hernia could be causing the heartburn I have from time to time. She told me I could take medicine when my heartburn is really bothering me. She also suggested that I try to lose some weight and eat right. I am hoping that these lifestyle changes, along with medicine when I have bad symptoms, will control my heartburn. Carlos, age 43 I was glad to learn that my chest pain was GERD. I thought I was having a heart attack. My doctor said I could treat the symptoms with medicine. But because I was having symptoms so often, he said the medicine would work best if I took it every day at the same time (30 minutes before breakfast). If I remember to take my medicine, I don't have any heartburn. Now I hope I will be able to get on with my life and not be bothered by this quite so much. Maria, age 28 My heartburn was really bad. I tried everything. First it was antacids and other medicines I bought at the drugstore. That didn't help, so I saw my doctor. He wrote me a prescription for stronger medicines. That helped some, but not enough. So after doing tests to make sure my symptoms were caused by GERD, my doctor said I could consider having surgery. He told me about the possible new symptoms I could have including trouble swallowing or burping and extra gas or bloating. But my GERD is so bad, I'm willing to take my chances. I decided to have surgery. Antoine, age 40 I decided to take medicine for my GERD instead of having surgery. It's not so much that I am afraid of surgery, but I really don't have the time to take off right now. Taking a pill every day is not that big a deal. If it works, great! And I don't know what new problems I might have after surgery. If medicine works for me, why would I try something more risky? Susan, age 50 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to take medicines for GERD Reasons to have surgery for GERD I'm not worried about the side effects of taking medicines. I want to avoid taking medicine or at least reduce how much medicine I'll need. I want to avoid having surgery if at all possible. I'm not worried about having surgery. I can make lifestyle changes and try different medicines. I have been trying medicines for some time, and my symptoms are still bad. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Taking medicine Having surgery Check the facts Decide what's next Certainty 1. How sure do you feel right now about your decision? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. GERD (gastroesophageal reflux disease) is the flow of stomach juices back up into the esophagus. This backup, called reflux, happens if the valve between the lower end of the esophagus and the stomach doesn't close tightly enough. The most common symptom is heartburn, an uncomfortable feeling of burning or pain just behind the breastbone. Another common symptom is a sour taste in the mouth. People with very bad, untreated GERD symptoms may get esophagitis (say "ee-saw-fuh-JY-tus"). This means that the esophagus is inflamed and irritated from the constant contact with stomach acids and digestive juices. GERD also can cause Barrett's esophagus, which is a change in the cells lining the esophagus. In rare cases, it may lead to cancer. Treatment usually starts with lifestyle changes—such as quitting smoking and losing weight—and with medicines that you can buy without a prescription. These medicines reduce or block stomach acid. They include H2 blockers (such as Pepcid) and proton pump inhibitors (such as Prevacid and Prilosec). Talk to your doctor if over-the-counter medicines aren't controlling your symptoms. In most cases, he or she can prescribe other medicine to help control your symptoms. The most common surgery for GERD is called fundoplication surgery. It involves wrapping part of the stomach around the esophagus to strengthen it. If you have a hiatal hernia, it also will be fixed. This surgery is often done laparoscopically. Instead of making a large cut (incision) in the belly, the doctor puts a lighted tube, or scope, and surgical tools into small cuts in your belly. This allows the doctor to see into your belly to do the surgery. You may decide to have surgery if: Lifestyle changes and antacids are usually tried first to treat pregnant women who have GERD. Some nonprescription antacids are safe to use during pregnancy to treat symptoms. Antacids that contain sodium bicarbonate can cause fluid to build up, so they should not be taken by pregnant women. And do not use antacids that have magnesium trisilicate, because they may not be safe for your baby. But it is okay to use antacids that contain calcium carbonate (such as Tums). Be careful when you take over-the-counter antacid medicines. Many of these medicines have aspirin in them. While you are pregnant, do not take aspirin or medicines that contain aspirin unless your doctor says it is okay. If lifestyle changes and antacids don't help control your symptoms, talk to your doctor about using other medicines. Medicines relieve GERD symptoms for most people. Proton pump inhibitors may work better than H2 blockers depending on your GERD symptoms, but you may need to try more than one medicine to find one that works well for you. And you may still sometimes need to take an antacid (such as Mylanta or Tums) to stop heartburn. No matter which medicines you try, making lifestyle changes is still an important part of your treatment. If your GERD symptoms are very bad, you will probably need to take medicines every day. That's because symptoms tend to return if you stop taking medicine. The medicines for GERD are generally safe, but each has different side effects. Surgery relieves symptoms for most people, but not for everyone. Laparoscopic surgery improves GERD symptoms in 8 out of 10 people. And surgery heals the damage done by GERD to the esophagus (esophagitis) in about 9 out of 10 people.1 All major surgery has risks, including a risk of breathing problems caused by the anesthesia. There also is a risk of bleeding, infection, and pain. Surgery for GERD can involve other problems: Your doctor might recommend surgery if: These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. "I was having tests for another health problem when my doctor discovered I have a hiatal hernia. She told me the hiatal hernia could be causing the heartburn I have from time to time. She told me I could take medicine when my heartburn is really bothering me. She also suggested that I try to lose some weight and eat right. I am hoping that these lifestyle changes, along with medicine when I have bad symptoms, will control my heartburn." — Carlos, age 43 "I was glad to learn that my chest pain was GERD. I thought I was having a heart attack. My doctor said I could treat the symptoms with medicine. But because I was having symptoms so often, he said the medicine would work best if I took it every day at the same time (30 minutes before breakfast). If I remember to take my medicine, I don't have any heartburn. Now I hope I will be able to get on with my life and not be bothered by this quite so much." — Maria, age 28 "My heartburn was really bad. I tried everything. First it was antacids and other medicines I bought at the drugstore. That didn't help, so I saw my doctor. He wrote me a prescription for stronger medicines. That helped some, but not enough. So after doing tests to make sure my symptoms were caused by GERD, my doctor said I could consider having surgery. He told me about the possible new symptoms I could have including trouble swallowing or burping and extra gas or bloating. But my GERD is so bad, I'm willing to take my chances. I decided to have surgery." — Antoine, age 40 "I decided to take medicine for my GERD instead of having surgery. It's not so much that I am afraid of surgery, but I really don't have the time to take off right now. Taking a pill every day is not that big a deal. If it works, great! And I don't know what new problems I might have after surgery. If medicine works for me, why would I try something more risky?" — Susan, age 50 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to take medicines for GERD Reasons to have surgery for GERD I'm not worried about the side effects of taking medicines. I want to avoid taking medicine or at least reduce how much medicine I'll need. I want to avoid having surgery if at all possible. I'm not worried about having surgery. I can make lifestyle changes and try different medicines. I have been trying medicines for some time, and my symptoms are still bad. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Taking medicine Having surgery 1.
Do frequent heartburn and other symptoms of GERD often go away on their own? 2.
Do many people get relief by making lifestyle changes and taking over-the-counter antacids? 3.
Will having surgery mean that you won't have to take medicines anymore? 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? 1.
How sure do you feel right now about your decision? 2.
Check what you need to do before you make this decision. Current as of: October 19, 2023 Author: Healthwise Staff Clinical Review BoardGERD: Which Treatment Should I Use?
GERD: Which Treatment Should I Use?
1
Facts2
Options3
Feelings4
Decision5
Yourself6
Get the facts
Your options
Key points to remember
What is GERD?
How is GERD treated?
Treating GERD in pregnant women
How well do medicines work for GERD?
The medicines
What are the side effects of GERD medicines?
How well does surgery work for GERD?
What are the risks and side effects of surgery?
Why might your doctor recommend surgery for GERD symptoms?
Compare your options
Personal stories about medicines and surgery to treat GERD
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?
Your Summary
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
Author Healthwise Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.GERD: Which Treatment Should I Use?
1. Get the Facts
Your options
Key points to remember
What is GERD?
How is GERD treated?
Treating GERD in pregnant women
How well do medicines work for GERD?
The medicines
What are the side effects of GERD medicines?
How well does surgery work for GERD?
What are the risks and side effects of surgery?
Why might your doctor recommend surgery for GERD symptoms?
2. Compare your options
Take medicines Have surgery What is usually involved? What are the benefits? What are the risks and side effects? Personal stories
Personal stories about medicines and surgery to treat GERD
3. What matters most to you?
4. Where are you leaning now?
5. What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
By Healthwise Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.