As part of a good acid reflux diet, take more but smaller meals and eat slowly. This reduces the risk of GERD, as there is less food in the stomach at any one time.

Eating large amounts of foods rapidly increases the pressure inside the stomach and worsens the symptoms of GERD. It is important to avoid food for 2 hours before bedtime. Also, avoid lying down after a meal.

Elevation of the upper body at night is recommended for all patients with GERD.

However, some patients experience acid reflux during the day only. It is therefore not possible to know for certain which patients will benefit from elevation at night. Acid testing has to be done to prove night reflux occurs.

Patients who have heartburn, regurgitation, and other symptoms of acid reflux at night should use upper body elevation.

Acid reflux also occurs less often when patients lie on their left sides rather than their right.

Making these changes to your sleeping habits as well as a good acid reflux diet should help alleviating the symptoms.

GERD Treatment Using Drugs

1. Antacids are normally prescribed for treatment of GERD. Antacids neutralize the acid in the stomach so that there is no acid to reflux.

Most antacids can be used in combination with other drugs. However, some can hinder the function of other medications.

Another problem with antacids is that their action is brief. They are emptied from the stomach quickly normally in less than an hour. The acid then re-accumulates. Patients should therefore take antacids about one hour after meals or just before the symptoms of reflux begin after a meal. This ensures the antacid stays in the stomach longer and is therefore effective longer.

2. Gastric H2 receptor blockers such as cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine, (Pepcid) can reduce gastric secretion of acid.

These drugs are antihistamines. They relieve complaints in about a half of all acid reflux patients. They are good at relieving heartburn but are not very good at healing the inflammation that may accompany GERD.

They are best taken 30 minutes before meals so that they can be at peak levels in the body after the meal when the stomach is actively producing acid. They can also be taken at bedtime to restrain production of acid overnight.

3. Proton pump inhibitors (PPI) such as omeprazole are the most effective in reducing gastric acid secretion. They stop the secretion of acid into the stomach at the source of acid production.

To maximize their effectiveness, they should be taken half an hour before meals.

4. Prokinetics strengthen the LES and speed up gastric emptying.

Surgical Acid Reflux Treatment

Nissen fundoplication is the standard surgical treatment if the acid reflux diet and medication is ineffective. On some occasions, it is preferred over long time use of medication.

During nissen fundoplication, the upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. The procedure is done laparoscopically.

Vagotomy is an obsolete treatment. Vagotomy is the surgical removal of vagus nerve branches that innervate the stomach lining. This treatment has been largely replaced by medication.

Other Acid Reflux Treatments

One system puts stitches in the LES to create little pleats that help strengthen the muscle.

Another system uses electrodes to create tiny cuts on the LES. When the cuts heal, the scar tissue helps toughen the muscle.

There is also an implant that may help people with GERD, who wish to avoid surgery. A solution is injected during endoscopy. It becomes spongy, reinforcing the LES to keep stomach acid from flowing into the esophagus.

This implant is approved for people who have GERD, and those who require and respond to proton-pump inhibitors. The long-term effects of the implant are unknown.