You may find the following measures can help reduce heartburn and other symptoms of GORD:
Eat smaller and more frequent meals, rather than three large meals a day – don't eat or drink alcohol within three or four hours before going to bed, and avoid having your largest meal of the day in the evening.
Avoid anything you think triggers your symptoms – common triggers include coffee, chocolate, tomatoes, alcohol, and fatty or spicy food.
Don't wear tight clothing – clothes that are tight around your tummy may make your symptoms worse.
Raise the head of your bed by up to 20cm (8 inches) – placing a piece of wood or blocks underneath one end of your bed may reduce symptoms at night; don't just use extra pillows, as this can put a strain on your tummy.
Try to relax – stress can make heartburn and GORD worse, so learning may help if you're often feeling stressed.
Maintain a healthy weight – if you're overweight, losing weight may help reduce your symptoms.
Stop smoking – smoke can irritate your digestive system and may make your symptoms worse.
If you're taking medication for other health conditions, check with your GP to find out whether they could be contributing to your symptoms.
Different medicines may be available, but don't stop taking any prescribed medication without consulting your GP first.
A number of different medications can be used to treat symptoms of GORD.
Over-the-counter heartburn and GORD medicines are available from pharmacies without a prescription. The main types are:
antacids – these neutralise the effects of stomach acid
alginates – these produce a coating that protects the stomach and oesophagus (gullet) from stomach acid
low-dose proton-pump inhibitors and H2-receptor antagonists – see below for more information about these
These medicines aren't suitable for everyone, so you should check the leaflet first. Ask a pharmacist for advice if you're not sure.
Proton-pump inhibitors (PPIs)
If your symptoms don't get better despite trying self-help measures and over-the-counter medicines, your GP may prescribe a PPI. These work by reducing the amount of acid produced by your stomach.
You'll usually be given enough medication to last a month. Go back to your GP if they don't help or your symptoms return after treatment finishes. Some people need to take PPIs on a long-term basis.
The possible side effects of PPIs are usually mild. They include dizziness and a rash.
Your GP will prescribe the lowest dose that they think will control your symptoms to reduce the risk of side effects.
H2-receptor antagonists (H2RAs)
If PPIs don't control your symptoms, a medicine known as a H2RA may be recommended for you to take alongside them on a short-term basis, or as an alternative.
Like PPIs, H2RAs reduce the amount of acid produced by your stomach.
Side effects of H2RAs are uncommon, but can include diarrhoea, headaches, dizziness, a rash and tiredness.
Surgery and procedures
Surgery may be an option if:
the above treatments don't help, aren't suitable for you, or cause troublesome side effects
you don't want to take medication on a long-term basis
The main procedure used is called a laparoscopic Nissen fundoplication (LNF). Alternative techniques have been developed more recently, although these aren't yet widely available.
Laparoscopic Nissen fundoplication (LNF)
LNF is a type of laparoscopic or "keyhole" surgery. This means it's carried out using special surgical instruments inserted through small cuts (incisions) in the skin.
The procedure is used to tighten the ring of muscle at the bottom of the oesophagus, which helps to stop acid leaking up from the stomach. It's carried out in hospital under general anaesthetic.
Most people need to stay in hospital for two or three days after the procedure. Depending on your job, you may be able to return to work within three to six weeks.
For the first six weeks after surgery, you should only eat soft food, such as mince, mashed potatoes or soup. Some people experience problems with swallowing, belching and bloating after LNF, but these should get better with time.
Newer operations and procedures
In the last few years, several new techniques for treating GORD have been developed.
Speak to your surgeon about these techniques for more information.
Complications of GORD
A number of possible complications can occur as a result of having gastro-oesophageal reflux disease (GORD) for a long time.
The stomach acid that leaks into the oesophagus in people with GORD can damage the lining of the oesophagus (oesophagitis), which can cause ulcers to form.
These ulcers can bleed, causing pain and making it difficult to swallow.
Medications used to treat GORD, such as proton pump inhibitors (PPIs), can help ulcers heal by reducing the amount of acid that leaks into the oesophagus. Read more about treatments for oesophageal cancer.
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