Life style changes
Several changes in lifestyle, related to individuals’ habits is recommended.

As mentioned before, reflux is more troublesome at night -when the individual is lying do-wn. Relief can be provided by elevating the patient’s upper body at night. This can be done by putting blocks under the bed’s feet on the head side. Also, reflux has been observed to occur less frequently -when the patient lies on his left side rather than on the right.

Alterations in eating habits is also recommended. Certain foods aggravate reflux. These should be religiously avoided. Chocolate, alcohol, caffeinated drinks, peppermint, fatty foods, spicy foods, citrus juices, carbonated drinks and tomato juice fall in this category. Smoking should be completely stopped.

Reflux is more after meals -when the stomach is distended -with food. Hence, smaller and earlier evening meals is recommended. A smaller meal distends the stomach less and an earlier evening meal -would mean that by bedtime, it has been digested and the stomach is empty. Therefore, reflux -will be less bothersome -when the patient lies do-wn.

Antacids
Antacids is the chief form of treatments for patients of GERD. They neutralize the acid in the stomach, thus leaving no acid to reflux. Ho-wever, their effect is brief as they empty out of the stomach quickly and subsequently, acid accumulates once again. An antacid, if taken one hour before a meal and then again taken approximately t-wo hours after it, is most effective in reducing reflux.

Histamine antagonists
As mentioned above, antacids is effective for a very short duration. Hence, histamine antagonists -were developed as a more long lasting remedy for treatment of acidrelated diseases, including GERD. The chemical Histamine produces acid in the stomach. Histamine antagonists prevent histamine from doing its -work.

Histamine produces acid, particularly after a meal. Therefore, histamine antagonists is best taken 30 minutes before a meal so that they at the peak of efficiency -when most of the acid is being produced.

Proton pump inhibitors
A proton pump inhibitor or PPI -was another type of drug developed for acidrelated diseases such as GERD. Like the histamine antagonists, a PPI also blocks off the production of acid in the stomach. Moreover, it does so for a longer duration than the histamine antagonist. Also, unlike the histamine antagonist, the PPI protects the esophagus from acid, allo-wing for esophageal inflammation to heal. PPI’s is used -when histamine antagonists is found to be inadequate.

Promotility drugs
Promotility drugs stimulate the muscles of the gastro intestinal tract. These include the esophagus, stomach, small intestine and/or colon. They heighten the pressure in the LES and boost the -wavelike contractions of the esophagus. Both these effects reduce acid reflux.

Surgery
Surgery is very effective in relieving the symptoms of GERD and is resorted to -when other means have proved to be inadequate. The surgical procedure that is undertaken to prevent reflux is kno-wn as fundoplication.

Endoscopy
In recent times, endoscopic treatments have been applied to deal -with GERD. In the first type of treatment, the LES isa is stitched, -which tightens the muscle. In the second type of treatment, radio frequency -waves is applied just above the LES. They cause a scar to form belo-w the esophageal lining. -when this scar shrinks, it pulls the surrounding tissue, thus tightening the LES isa. There is yet another type of endoscopic treatment in -which material is injected into the esophageal -wall, in the LES isa. This raises the pressure on the LES, thus preventing reflux.