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foods that are not well tolerated is always recommended. Known culprits are fatty foods, chocolate and black pepper. Other foods such as spicy foods, dairy, coffee, tea and citrus fruits cause problems for some GERD patients, but not others. Keeping a food diary with notes of which items seem to cause trouble, is useful. Large meals and eating just before bedtime should be avoided.

Also, alcohol and tobacco use should be eliminated or curtailed. Weight loss may be recommended since obesity is a contributing factor for GERD. Elevating the head of one's bed several inches is sometimes recommended in order to prevent GERD symptoms during sleep.

Many GERD sufferers take over the counter antacids (calcium carbonate, sodium bicarbonate, or combinations of aluminum hydroxide, magnesium hydroxide, magnesium carbonate and simethicone). However, these are generally appropriate for short term use only. Antacids can mask serious underlying problems, and use of antacids over extended periods of time can cause "acid rebound", an increased production of stomach acid. This makes antacids an inadequate solution for GERD.

To treat GERD, doctors prescribe acid blockers that decrease production of stomach acid rather than neutralize it. They fall into one of two categories:

* Histamine receptor 2 blockers(ranitidine, famotidine, cimetidine, nizatine), which reduce acid secretion at the hormonal level, and are available over the counter under various brand names, some in combination with an antacid.

*Proton pump inhibitors (esomeprazole, lansoprazole, pantoprazole, omeprazole, rabeprazole). (PPIs), which block acid production directly in the lining of the stomach. These are available by prescription only. These are available by prescription only. They are highly effective in healing esophagitis, and are currently the preferred prescribed acid reducers.

Because GERD can cause serious damage to the esophagus and also contribute to other health problems, GERD that does not respond adequately to medication is sometimes treated surgically.

* The most common GERD surgery is fundoplication, a procedure in which a portion of the upper part of the stomach is wrapped around the LSE to provide reinforcement. Fundoplication is usually done laparoscopically.

* Endoscopic surgery, currently performed on an investigational basis, accomplishes the tightening of the LSE by means of either placing sutures around the LSE, or using methods to induce formation of scar tissue on the LSE.

* Other physical anomalies that contribute to GERD are often addressed as part of GERD surgery, including correction of hiatal hernia and/or tightening the opening of the diaphragm through with the esophagus passes.

GERD surgery is reported to be highly effective. Possible side effects of surgery include impaired ability to belch or vomit, and bloating. Occasionally reoperation is necessary.

Learn more about this author, Ysabel J. Doran.
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