From the Guidelines
The recommended treatment for GERD is a step-up approach starting with lifestyle modifications and progressing to medications if needed, with proton pump inhibitors (PPIs) being the most effective medication class, as supported by the most recent and highest quality study 1.
Key Lifestyle Modifications
- Weight loss if overweight
- Avoiding trigger foods (spicy, fatty, acidic foods, chocolate, caffeine)
- Eating smaller meals
- Not lying down for 2-3 hours after eating
- Elevating the head of the bed by 6-8 inches
- Quitting smoking
Medication Therapy
- Antacids like Tums or Rolaids for quick but temporary relief
- H2 blockers such as famotidine (Pepcid) 20mg twice daily or ranitidine (Zantac) 150mg twice daily to reduce acid production
- PPIs, including omeprazole (Prilosec) 20mg daily, esomeprazole (Nexium) 40mg daily, or pantoprazole (Protonix) 40mg daily, typically taken 30 minutes before breakfast, as the most effective medication class
Treatment Approach
- Initial trial of empirical acid-suppressive therapy with once-daily PPIs for 4-8 weeks
- Escalation to twice-daily therapy if once-daily therapy is unsuccessful
- Further investigation with endoscopy if 4-8 weeks of twice-daily empirical PPI therapy is unsuccessful, as recommended by 1 and 1
- Use of the lowest effective dose of medication for the shortest duration necessary to control symptoms, with consideration of long-term therapy for some patients, as suggested by 1 and 1
Severe Cases
- Surgical options like Nissen fundoplication may be considered for severe cases unresponsive to medical therapy, as mentioned in 1
From the FDA Drug Label
Omeprazole delayed-release capsules are indicated for the treatment of heartburn and other symptoms associated with GERD for up to 4 weeks in patients 2 years of age and older. Omeprazole delayed-release capsules are used: • for up to 4 weeks to treat heartburn and other symptoms that happen with gastroesophageal reflux disease (GERD). The recommended treatment for Gastroesophageal Reflux Disease (GERD) is omeprazole delayed-release capsules for up to 4 weeks to treat heartburn and other symptoms associated with GERD in patients 2 years of age and older 2.
- Key points:
- Treatment duration: up to 4 weeks
- Patient age: 2 years and older
- Indication: treatment of heartburn and other symptoms associated with GERD
- Medication: omeprazole delayed-release capsules 2
From the Research
Gerd Treatment
The recommended treatment for Gastroesophageal Reflux Disease (GERD) includes:
- Proton pump inhibitors (PPIs) as the primary treatment option, due to their potent and prolonged suppression of gastric acid 3
- Omeprazole, a type of PPI, has been shown to be effective in resolving GERD symptoms and promoting esophageal healing 4, 5, 6
- Combination therapy with PPIs and histamine(2) receptor antagonists may be considered, but its effectiveness is still being studied and has not been proven to provide significant benefits 7
Treatment Options
Some treatment options for GERD include:
- Omeprazole 20 mg once daily, which has been shown to provide faster and more complete resolution of common GERD symptoms than ranitidine alone or in combination with metoclopramide 4
- Lansoprazole, rabeprazole, and pantoprazole, which are also PPIs available in the United States, have similar efficacy and safety profiles to omeprazole 3
- Ranitidine, a histamine(2) receptor antagonist, may be used, but it has been shown to be less effective than omeprazole in resolving GERD symptoms 4, 5
Efficacy and Safety
The efficacy and safety of GERD treatments have been studied, with results showing:
- Omeprazole provides significantly higher rates of endoscopic healing than ranitidine alone or with metoclopramide 4
- PPIs, including omeprazole, have been shown to be safe and well-tolerated, with a low incidence of adverse events 4, 3
- The addition of metoclopramide to ranitidine has been shown to increase adverse events 4