Gastroesophageal reflux disease, commonly known as GERD, is a long-term digestive condition in which stomach acid or partially digested food repeatedly flows back into the esophagus, the tube that connects the mouth to the stomach. This backward flow, called acid reflux, happens when the lower esophageal sphincter does not close properly.

Factors that increase your risk of GERD include:

• Obesity: Increases pressure on the stomach, pushing acid into the esophagus.
• Pregnancy: Hormonal changes and added abdominal pressure raise reflux risk.
• Hiatal Hernia: Allows part of the stomach to move upward, weakening the acid barrier.
• Smoking: Weakens the lower esophageal sphincter and reduces saliva that neutralizes acid.
• Dietary Habits: Frequent intake of fatty, spicy foods, chocolate, caffeine, citrus, tomatoes, alcohol, and carbonated drinks.
• Large Or Late Meals: Overeating or lying down soon after eating promotes reflux.
• Certain Medications: Some pain relievers, muscle relaxants, blood pressure drugs, and sedatives can worsen reflux.
• Delayed Stomach Emptying (Gastroparesis): Keeps food and acid in the stomach longer, increasing reflux risk.

Healthcare providers usually start with lifestyle changes and over-the-counter medicines, and if symptoms don’t improve in a few weeks, prescription medications and further tests may be recommended.

Medication Options: If lifestyle changes aren’t enough, treatment may include antacids for quick relief by neutralizing stomach acid, H2 blockers to reduce acid production, and proton pump inhibitors (PPIs), which are stronger acid blockers that also help heal irritation of the esophagus. Potassium-competitive acid blockers are a newer option for people who don’t respond well to standard medicines. Depending on severity, these medicines may be over-the-counter or prescription.

Nonprescription Medicines For GERD: Over-the-counter options include antacids, such as calcium carbonate products, which provide quick relief by neutralizing stomach acid but do not heal esophageal damage and may cause side effects if overused. H2 blockers reduce acid production and offer longer-lasting relief than antacids, while proton pump inhibitors (PPIs) are stronger acid blockers that reduce acid more effectively and help heal irritated esophageal tissue.

Prescription Medicines: For more severe acid reflux, doctors may prescribe stronger proton pump inhibitors (PPIs) like esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole, or dexlansoprazole, which reduce stomach acid and help heal the esophagus. They are usually well tolerated but can sometimes cause headache, diarrhea, nausea, or rarely low vitamin B12 or magnesium. Prescription-strength H2 blockers, such as famotidine and nizatidine, are another option with mild side effects. For cases that don’t respond to these treatments, potassium-competitive acid blockers (P-CABs) like vonoprazan or tegoprazan may be recommended.

Surgery And Advanced Procedures : If medicines and lifestyle changes don’t provide enough relief, surgical or minimally invasive options may be considered. These include fundoplication, which tightens the valve between the stomach and esophagus; the LINX device, a magnetic band that helps prevent reflux; and transoral incisionless fundoplication (TIF), an endoscopic procedure that tightens the valve without external incisions. These approaches reduce reflux by mechanically strengthening the barrier against acid, rather than using medications.

Fundoplication: Fundoplication is a minimally invasive (laparoscopic) surgery in which the top of the stomach is wrapped around the lower esophageal sphincter to strengthen it and prevent acid reflux. The wrap may be complete (Nissen fundoplication) or partial, most commonly the Toupet fundoplication, with the specific type chosen by the surgeon based on the patient’s condition.

LINX Device: The LINX device is a small ring of magnetic beads placed around the junction of the stomach and esophagus using minimally invasive surgery. The magnets keep the valve closed to prevent acid reflux while still allowing food to pass through, and they do not interfere with airport security or MRI scans.

Transoral Incisionless Fundoplication (TIF): TIF is a minimally invasive procedure that tightens the lower esophageal sphincter by creating a partial wrap around the lower esophagus using an endoscope passed through the mouth. It requires no surgical incisions and offers quick recovery with good patient tolerance.