“How can I reduce acid reflux?”
—Sherie, Gainesville, Florida
Acid reflux (gastroesophageal reflux disease, or GERD) is one of those complaints where the treatment sits on the fence between self-care and professional medical care. For young, healthy people, the causes are usually not serious.
Acid reflux is often the product of two related problems:
- An excess of digestive acids in the stomach.
- The muscle at the end of your esophagus, called the esophageal sphincter, not closing properly. This allows stomach content, including stomach acid, to leak back into your esophagus and cause irritation.
Sometimes there are clear causes or related conditions:
- Pain relievers, such as ibuprofen or naproxen, can thin the stomach’s protective lining.
- Coffee, alcohol, cigarettes, and spicy foods can irritate the stomach lining or cause the esophageal sphincter to have difficulty functioning.
- Excess stomach gas, which can develop from taking in too much air while eating fast or drinking carbonated beverages, may aggravate symptoms.
- High-acid foods such as tomatoes and citrus fruits may make symptoms worse in people who are sensitive to acid reflux.
The common symptoms of acid reflux are a burning sensation in your chest and/or a sour liquid coming up into your throat, sometimes during a burp.
Reflux tends to be worse when lying down. It can cause a sore throat, hoarse voice, and can make asthma worse.
There are many effective medications that you can take without a prescription. But if your symptoms are not responding to over-the-counter options, you may need to visit your school nurse or your primary health care provider.
The four main treatment options are:
- Behavior change
- Acid neutralizers
- H2 blockers
- Proton pump inhibitors
Behavior change means adjusting some of your habits to keep from making the symptoms of acid reflux worse. For example, as much as I love coffee, I had to stop drinking it because it caused me gastritis (stomach wall irritation) and reflux from GERD. Here are some things you can do:
- Sleep with your head elevated—try using an extra pillow.
- Avoid spicy and acidic foods, especially when you’ve been having symptoms.
- Stay away from coffee, alcohol, and cigarettes.
- Try not to take certain pain relievers, such as ibuprofen, naproxen, and aspirin.
Acid neutralizers, such as Tums®, include calcium carbonate and can provide temporary relief. For minor cases these may be effective.
H2 blockers, sometimes called acid reducers (such as cimetidine, famotidine, nizatidine, and ranitidine), can be found over-the-counter in low doses or may be prescribed by a doctor.
Proton pump inhibitors (PPIs), such as lansoprazole, omeprazole, and esomeprazole, are highly effective and some are now available without a prescription. They’re often immediately effective, but a week or more of daily use (best taken 30 minutes before breakfast) may be necessary for complete relief. This allows time for the esophageal sphincter to heal after acid concentrations have lowered.
If a week of daily PPI use isn’t helping, or if symptoms recur soon after stopping several weeks’ use, it’s time for another appointment with your health care provider to talk about additional causes and potential treatments.