How Long Will I Need Treatment for GERD?

By: Elizabeth Scherer

You may be wondering what you can expect over the course of your treatment: how quickly it will help you feel better, how long you might need to take medications, or how long you might need to make lifestyle changes.

What is the treatment process?

GERD treatment is based on whether your symptoms are mild, moderate, or severe. To learn more about these levels of symptoms and how they might impact your life, see What are the levels of GERD symptoms? After your doctor has determined how severe your symptoms are, he or she will work with you to develop an initial treatment plan. Both you and your doctor will determine whether this plan is right for you or whether adjustments should be made.

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Like high blood pressure, GERD is considered a chronic condition, meaning that it can be controlled but not cured by medications. People who have more severe symptoms or greater damage to the esophageal tissues, or whose symptoms return as soon as medication is stopped, often need ongoing treatment to control and relieve symptoms. This type of ongoing, long-term treatment is known as maintenance treatment.

Initial treatment for mild-to-moderate GERD. The first step in treating mild-to-moderate GERD symptoms is lifestyle changes. Your doctor will recommend changes based on many factors in your everyday life that may contribute to your symptoms.

Along with these changes, your doctor may also recommend any of the following medications to use on an "as-needed" basis, which means that you can use them whenever symptoms start or before symptoms occur: antacids, alginic acid/antacids combinations, or H2 blockers. All of these medications are available over the counter.

Initial treatment for moderate-to-severe GERD.With moderate-to-severe GERD, lifestyle changes are also important. However, rather than take medication as needed, moderate-to-severe GERD is treated continuously for 6 to 12 weeks, sometimes even longer. Your doctor will select medications based on the severity of your symptoms and whether or not reflux has damaged your esophagus.

Maintenance treatment for persistent-but-mild GERD. People who require maintenance treatment may be directed to take either antacids or H2 blocker medication on a regular schedule rather than taking them "as needed." Your doctor will determine the best schedule for you. Using an H2 blocker medication and making lifestyle changes works well to control symptoms and heals about 50% of people with GERD. H2 blockers are used to prevent and relieve symptoms of heartburn and sour stomach, while antacids are best for rapid relief of symptoms and can be taken immediately after meals as well as within 1 to 3 hours of bedtime.

Maintenance treatment for persistent moderate-to-severe GERD. People who have more severe symptoms, greater damage to the esophageal tissues, or whose symptoms return as soon as medication is stopped often need ongoing treatment to control and relieve symptoms. This type of ongoing, long-term treatment is known as maintenance treatment. Maintenance treatment requires aggressive measures to block the production and release of stomach acid. The American College of Gastroenterology recommended a new approach for treating chronic GERD in 1999. This method uses proton pump inhibitors, such as Prevacid, Prilosec, Aciphex, and Protonix. They are also used when complications such as esophagitis fail to heal with regular treatment. Studies show that these medications effectively control symptoms for at least a year in more than 75% of people with GERD. They are generally taken once a day, in the morning before breakfast. However, higher doses of proton pump inhibitors may be necessary in very severe GERD or in people who don't respond to treatment.

How soon will the medications work?

Some medications, such as antacids, work right away. Others take days to weeks before you notice a difference in your symptoms. Your response depends on how severe your GERD symptoms are and what treatment plan you're following. Always ask your doctor how soon you can expect relief.

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GERD Treatment FAQ

How long does GERD take to heal?
GERD isn't something that can be totally eliminated for most people. However, using an H2 blocker medication and making lifestyle changes works well to almost entirely control symptoms for about 50 percent of people.
Is GERD curable or not?
GERD is considered a chronic condition, meaning that it can be controlled and treated, but not cured.
Why does GERD get worse at night?
When you lay down flat, gravity stops moving food and acid down the esophagus and through the digestive system, allowing the acid to pool in place and increase heartburn. Similarly, swallowing is an important force that pushes stomach acid downward, but this action is significantly reduced during sleep.
What foods should be avoided with GERD?
Unfortunately, the list of foods you should avoid if you have GERD is pretty long. Foods to skip include spicy, fried, and high-fat foods. You should also avoid tomatoes, citrus fruits, pineapple, garlic, onions, alcohol, coffee, and carbonated drinks. You should also reduce your intake of processed foods, as they can cause your lower esophageal sphincter to function poorly, increasing GERD symptoms.
What is the biggest indicator of GERD?
Heartburn is the most frequent, though not the only, symptom of GERD.
What is the first line of treatment for GERD?
Initial treatments usually involve making lifestyle changes. Your doctor may also suggest using over-the-counter medications like antacids, alginic acid/antacids combinations, or H2 blockers on an "as-needed" basis or whenever symptoms flare up.