There are three major classes of GERD medications for treating gastroesophageal reflux (GERD). They include antacids, H2 receptor blockers, and proton pump inhibitors. Additionally several surgical procedures are available to reduce GERD.
Antacids provide immediate, short-term relief from GERD symptoms by temporarily neutralizing acids in the esophagus. These can be used anytime to decrease the symptoms of GERD but do not provide a long-term solution as their effects only last a few minutes before symptoms return.
2. H2 Receptor Blockers
H2 Receptor Blockers work by blocking the H2 receptor that signals cells in the stomach to produce acid. These are considered first-line agents in reducing the symptoms of GERD and preventing symptom relapse. They are also effective at healing the esophageal inflammation that can result from excess stomach acid in the esophagus. These agents do not work as quickly as antacids but provide long-term relief from GERD symptoms.
Examples include ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid).
3. Proton Pump Inhibitors (PPIs)
PPIs also work to decrease acid production by the stomach but by a different mechanism than H2 Receptor Blockers. These are the most effective agents at reducing and preventing GERD symptoms as well as the esophageal inflammation that may occur as a result of excess stomach acid. Also, like H2 blockers, PPIs do not work as quickly as antacids but provide long-term relief from GERD symptoms. PPIs are also generally safe and well tolerated medications, although studies have shown that they may increase the risk of hip fractures in postmenopausal women.
Examples include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), and pantoprazole (Protonix).
Several surgical procedures are available to reduce or eliminate GERD symptoms. These procedures are generally performed when GERD symptoms cannot be controlled by medical therapy alone or when patients desire a definitive treatment to eliminate the need for medical therapy. If you think that surgical intervention may be necessary for your GERD symptoms, please discuss available options with your physician.