What tests confirm a diagnosis of GERD?
An endoscopy may be used to diagnose GERD. This is a procedure in which a fiber-optic tube is passed down into the esophagus through the mouth. This tube relays images to a video monitor, which enables the doctor to see any ulcers or inflammation that may be present. A biopsy to exclude or confirm Barrett’s esophagus can also be taken during an endoscopy (a biopsy involves taking a small sample of cells for examination under a microscope). A barium swallow test may sometimes be used for diagnosis. This involves swallowing a harmless liquid that shows up on x-ray. If reflux causes the liquid to come back up into the esophagus, it will be seen on an x-ray.

How is GERD treated?
Treatment usually involves a combination of medication, weight reduction if necessary, and changes in diet and lifestyle. Weight loss can greatly reduce symptoms in obese people. Avoidance of certain foods (such as caffeinated and/or carbonated drinks, chocolate, fatty foods, alcohol, and spicy foods) and stopping smoking can help to prevent reflux. Eating meals at least three hours before lying down or going to bed and elevating the head of the bed a few inches may also help to prevent stomach contents flowing back up into the esophagus. There are various types of medication available that can help to control the symptoms of GERD but do not necessarily cure the condition.

Antacids (Alka-Setlzer, Maalox, Rolaids, Tums) are given to suppress reflux and to relieve symptoms, particularly heartburn. These include ingredients such as aluminum hydroxide, calcium carbonate, magnesium hydroxide,  simethicone and sodium bicarbonate. Most of the available preparations contain a combination of these ingredients. They may be in liquid, tablet or capsule form and may be prescribed by a doctor or bought from a pharmacist.

H2-receptor antagonists such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) or ranitidine (Zantac) are taken daily to reduce the production of acid. These are available on prescription and in some cases lower strength preparations are available over the counter in pharmacies.

Proton pump inhibitors such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) and rabeprazole (Aciphex) are another type of drug, which may be given regularly to cut down the acid production of the stomach and promote the healing of ulcers. Proton pump inhibitors are only available by prescription, with the exception of omeprazole and lansoprazole.

Antidopaminergic drugs help emptying of the stomach, and include  metoclopramide (Reglan). These medicines are available by prescription.

Further information
National Digestive Diseases Information Clearinghouse (NDDIC): http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.aspx

Last Reviewed: May 2013