Almost everyone has a case of heartburn every once in a while. An oversized meal or particularly spicy food causes you to feel a distinctive, painful sensation in your chest or back of your throat. But when you get heartburn multiple times a week and certain foods aren’t necessarily the cause, it might be more than heartburn. It might be gastroesophageal reflux disease (GERD). GERD can be most easily described as persistent heartburn.

People with GERD have a malfunctioning lower esophageal sphincter (LES), which can either open sporadically or fail to close properly. This gives the acid in your stomach an opportunity to rise up into the esophagus. When that stomach acid makes contact with your esophagus and throat, it causes irritation.

There are a number of short-term drug treatments for gastroesophageal reflux disease.

Antacids

Antacids are the most common short-term solution to heartburn and GERD. Antacids neutralize acid in the stomach and can be purchased over-the-counter without a prescription. Antacids are designed to provide immediate, short-term relief from heartburn. They are not meant as a long-term treatment strategy.

Foaming agents

Foaming agents are over-the-counter drugs taken orally. They expand and cover your stomach with foam, stopping digestive acid from reaching the esophagus. Foaming agents are another short-term solution like antacids and are ineffective against esophagus damage.

For people dealing with GERD over the long term, more powerful options may be necessary. They include proton pump inhibitors, histamine blockers, and prokinetic agents.

Proton Pump Inhibitors

Proton pump inhibitors, or PPIs, are used to treat serious cases of GERD. Unlike antacids that neutralize acid in the stomach, PPIs lower the amount of acid your stomach produces. As a result, if reflux occurs and stomach juices rise into the esophagus, there will not be enough acid present to cause damage. PPIs are extremely effective at healing the esophagus. Eight out of 10 people see improvement, because the lowered amount of acid provides time for the damaged esophagus to heal. PPIs can even relieve some of the more alarming GERD symptoms such as esophagitis, ulcers, and even Barrett's esophagus.

Within six to eight weeks, damage to the esophagus can be healed, but that does not signal the end of therapy. Withdrawal of PPIs would most likely increase the amount of stomach acid, and start the cycle over. PPIs do not necessarily cure GERD, since it can be chronic, but they are safe to use long term and can effectively control the symptoms. Most people respond well to the medication, but it has been known to produce side effects. Headache and diarrhea are common and, in some cases, PPIs can reduce the ability for your body to absorb calcium.

H2, also known as histamine blockers, have been in use since the 1970s and work similarly to proton pump inhibitors by blocking stomach acid production. H2 blockers are available in non-prescription and prescription forms. Nonprescription can only be taken for two weeks to provide short-term relief.

H2 blockers only provide relief in half of the people with GERD. They are also less effective than PPIs, especially when it comes to treating the more serious symptoms of GERD. They can be used in tandem with antacids or PPIs to increase effectiveness. The antacids neutralize the acid while the H2 blockers stop acid production. Typical side effects of H2 blockers include headache, diarrhea, nausea, and vomiting.

There are also prescriptions designed to assist the main cause of GERD: a malfunctioning lower esophageal sphincter. These are known as prokinetics. They work to tighten the lower esophageal sphincter, which can prevent backflow of acid.  They also contract the stomach more frequently, allowing contents to empty faster and avoiding reflux. 

Prokinetic agents are a less common approach to treating GERD because they come with a litany of side effects that prevent them from being completely effective. Side effects include:

• Fatigue

• Anxiety

• Problems with the nervous system and physical movement

• Feelings of depression

The severity of gastroesophageal reflux disease will dictate the type of treatment you need. Your doctor will be able to help you decide which drug is right for you.