Treatment of acid reflux mainly relies on lifestyle changes that prevent attacks. Acid reflux is one of the commonest digestive disorders affecting millions of people worldwide at some point in their lives.

Lifestyle changes to relieve and prevent heartburn

Some of the lifestyle changes that can relieve and prevent attacks of heartburn and acid reflux include:-

• Eating small and frequent meals
• Eating a healthy, non-spicy, non-fatty and balanced meal. The last meal of the day should be taken at least 4 hours before bed. Lying down immediately after a meal may aggravate heartburn.
• Avoidance of food and beverage triggers of heartburn including alcohol, coffee, chocolate, tomatoes, citrus fruits etc.
• Maintaining a normal body weight.
• Quitting smoking.
• Avoidance of wearing tight clothes especially around the abdomen.
• Raising the head end of the bed by about 20 cm (8 inches).

Medications for heartburn

For patients who do not respond to these measures diagnostic methods to evaluate the extent of esophagitis or esophageal damage and gastroesophageal reflux should be employed. Medication may be required in these patients.

Medications help in neutralizing the gastric acid or by reducing the acid production. There are another group of agents called prokinetics that increase the motility of the gastrointestinal system and thus allow food to be transmitted through the esophagus and gut faster.

Drugs used in acid reflux include:-

Antacids

These agents are available over the counter. They work by neutralizing the gastric acid and relieve the symptoms of heart burn and acid reflux. These drugs, however, cannot be taken along with other medications that reduce acid reflux and there may be significant interactions leaving these agents ineffective.

Alginates

These agents are also available over the counter without prescription. These agents work by producing a protective coating that shields the lining of the stomach and esophagus. This protects the vulnerable linings of mucosa from the acid.

Proton-pump inhibitors (PPIs)

These are prescription medications like Omeprazole, Pantoprazole, Rabeprozole and Lansoprazole. These work by reducing the acid produced by the stomach. Patients with gastroesophageal reflux disorder may require PPIs for a long duration.

H2-receptor antagonists

These include Ranitidine, Cimetidine and Famotidine. These agents block the effects of the chemical histamine that helps produce stomach acid. Thus these agents reduce the acid production.

Prokinetic agents

These include Bethanechol and Metoclopramide. These agents hasten movement of food via stomach to the intestines and reduce the risk of reflux.