Initial Treatment

Peter J. Lydon, MD, FACS
The first treatment of serious heartburn or GERD should be simple lifestyle changes. Diet modification is first. Some foods increase stomach acid and/or decrease LES pressure and should be avoided. These are:

  • Foods with caffeine such as coffee, tea, cola drinks and chocolate
  • Fried and fatty foods, spicy foods and acidic foods such as citrus fruits and tomatoes
  • Onions
  • Peppermint
  • Small meals are better than large meals, and, after eating it is best not to bend over, lie down or go to sleep for at least three hours.
  • Both smoking and drinking alcohol will substantially increase stomach production of acid; LES pressure is lowered by alcohol. Smoking and drinking alcohol should be stopped. Check medications to be sure they do not contain alcohol or caffeine-like substances.

Excess weight, particularly in and on the abdomen or belly, increases pressure on the stomach and causes more reflux of acid. Tight clothing and frequent bending over may also cause more reflux. Sleeping with the head of the bead elevated about 6 inches may also help to keep acid from refluxing at night.

If symptoms persist despite these life style modifications then it is best to see your doctor. Gallbladder attacks, stomach or duodenal ulcers or merely irritation (gastritis) and narrowing of the arteries to the heart (coronary arteriosclerosis or spasm) may cause symptoms similar to heartburn.

Your doctor might prescribe medications that reduce the production of acid by the stomach and medications that increase peristalsis in the esophagus; or your doctor might refer you to a gastroenterologist.