Gastroesophageal Reflux Disease (GERD)

Over-the-counter acid buffers - Buffers that neutralize acid include Mylanta, Maalox, Tums, Rolaids, Gaviscon and others. The liquid forms of these medications work faster, but the tablets may seem more convenient to you. Because antacids that contain magnesium can cause diarrhea and antacids that contain aluminum can cause constipation, your doctor may advise you to alternate antacids to avoid these problems. These medicines work for a short time and they do not heal the inflammation of the esophagus.

Over-the-counter H2 blockers - These drugs work by causing the stomach to make less acid, and they are effective in patients with mild to moderate symptoms. They include famotidine (Pepcid AC), cimetidine (Tagamet HB) and ranitidine (Zantac 75).

Over-the-counter proton pump inhibitors - An over-the-counter form of omeprazole (Prilosec OTC) is one of several medicines that block the pump mechanism in the stomach's acid-making cells, shutting off the stomach's acid production. Proton pump inhibitors are very effective medications that can be especially helpful in patients who do not respond to H2 blockers and antacids. These drugs are more potent acid-blockers than are H2 blockers, but they take longer to begin their effect. They should not be combined with an H2 blocker, because the H2 blocker can prevent them from working due to a drug interaction.

Prescription medications - Prescription medications include:

• H2 blockers - These are prescribed at higher doses than those available in over-the-counter forms.

• Proton pump inhibitors - A variety of proton pump inhibitors are available by prescription, including omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), and rabeprazole (Aciphex).

• Motility drugs - These medications may help to decrease esophageal reflux, but usually are not used as the only treatment for GERD. They help the stomach to empty faster, which decreases the amount of time during which reflux can occur. The most commonly prescribed motility drug is metoclopramide (Reglan).

• Mucosal protectors - These medications coat, soothe and protect the irritated esophageal lining. One example is sucralfate (Carafate).