Lifestyle changes — including quitting smoking and losing weight, as well as changes in certain food-related habits — can be effective treatments for GERD.
Medications can reduce and relieve GERD symptoms like heartburn, and some also allow the esophagus to heal from damage caused by acid reflux, according to the American College of Gastroenterology.
Most people with GERD start with an over-the-counter (OTC) drug. If your symptoms don’t improve within a few weeks, your doctor may prescribe a prescription drug to take instead.
For people whose GERD doesn't go away after medication or lifestyle changes, surgery may be an effective option, according to Mayo Clinic.
“In general, the key to managing GERD symptoms is lifestyle modifications,” says Catiele Antunes, MD, an assistant professor of medicine and the director of the Refractory GERD Clinic at Yale School of Medicine. “This cannot be emphasized enough. That includes avoiding triggers, maintaining a healthy weight, avoiding late meals, raising the head of the bed, and so on.”
Here are some of the lifestyle strategies that can get GERD symptoms under control.
Quit Smoking
Smoking weakens the lower esophageal sphincter, making reflux more likely.
Research suggests the health risks of smoking increase the longer and more heavily you smoke.
Maintain a Healthy Weight
Abdominal fat can cause acid to rise up into the esophagus by pressing on the stomach. A healthy diet and regular exercise can help you maintain a healthy weight, or lose weight if necessary. Talk to your healthcare provider about designing an eating and exercise program that’s right for you.
Wear Loose-Fitting Clothing
Tight clothing can increase pressure on your abdomen, pushing the stomach contents upward. Loose-fitting clothing will help keep you comfortable without worsening GERD symptoms.
Manage Stress
High stress levels appear to increase the risk of GERD and may even worsen the symptoms. Stress may also reduce the effectiveness of treatment.
Meditation, journaling, and other stress-management techniques can reduce stress. If they don’t help, ask your doctor about other options.
Various foods and ingredients can increase your risk of heartburn and GERD, while others may reduce it. Keep in mind, however, that not every person is affected by every food. If a food doesn’t bother you, there’s no need to avoid it.
Foods to Avoid
Foods that may trigger reflux include:
Alcohol
Caffeine
Chocolate
Fatty or fried foods
Garlic
Onion
Citrus fruits
Spicy foods
Tomato sauces
Vinegar
Peppermint
Carbonated beverages
Foods to Eat
The following foods are less likely to cause reflux:
Bananas, melons, apples, and other non-citrus fruits
Vegetables, eaten raw or plain
Lean meats
Oatmeal, rice, couscous, and whole-grain bread
Olive, canola, sunflower, and other unsaturated vegetable oils
Other Dietary Tips
Here are some other dietary tips for managing GERD symptoms:
Eat smaller meals more often.
Eat slowly and chew your food thoroughly.
Avoid eating three to four hours before bedtime.
Wait two to three hours after eating before you lie down.
Avoid vigorous exercise for two hours after eating.
If lifestyle remedies don’t help, you might need over-the-counter (OTC) or prescription medication to manage GERD symptoms.
Antacids are often the first type of drug doctors recommend to relieve heartburn and mild symptoms of GERD. They can offer quick relief by neutralizing stomach acid. But they’re not suitable to use daily or for severe symptoms. They can also lead to diarrhea or constipation.
Antacids are widely available over the counter and include:
aluminum hydroxide and magnesium hydroxide (Mylanta)
calcium carbonate and magnesium hydroxide (Rolaids)
calcium carbonate (Tums)
A pharmacist can advise you on how to choose an antacid; always let them know what other drugs you are taking in case there are interactions. If you’ve been using one of these remedies for two weeks and still have symptoms, speak with a doctor.
H2 Blockers
H2 blockers are drugs that reduce acid production. They don’t work as fast as antacids, but they are more effective.
Your doctor may recommend an H2 blocker alongside an antacid to treat heartburn after meals.
Over-the-counter options include:
cimetidine (Tagamet)
famotidine (Pepcid)
Stronger versions are available with a prescription.
Proton Pump Inhibitors (PPIs)
PPIs reduce acid production, offering relief from symptoms and helping your esophagus heal. They offer a long-term treatment for more severe symptoms.
The following PPIs are suitable for short-term treatment.
Over-the-counter options include:
omeprazole (Prilosec)
lansoprazole (Prevacid)
esomeprazole (Nexium)
Prescription-only options include:
pantoprazole (Protonix)
rabeprazole (Aciphex)
dexlansoprazole (Dexilant)
According to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), PPIs are generally safe and effective, although they may increase the risk of Clostridioides difficile (C. diff) infection.
Research into the potential risks of high doses or long-term use of PPIs is ongoing.
If you find you need to take a PPI for longer than 14 days, talk to your doctor. You may be masking underlying issues that need to be addressed.
Potassium-Competitive Acid Blockers (PCABs)
Vonoprazan (Voquezna), a potassium-competitive acid blocker (PCAB), works by blocking stomach acids and has been shown in studies to significantly reduce heartburn episodes in patients with non-erosive GERD.
PCABs are not routinely used in the United States and are not recommended as a first-line drug treatment for GERD, as their long-term effects are not yet known.
A surgical procedure may be the best option for managing GERD if other strategies haven’t been effective or are inappropriate for you.
All procedures strive to tighten the lower esophageal sphincter by pulling the stomach down and then using it to wrap around the esophagus.
Fundoplication
Fundoplication is a minimally invasive procedure and the most common type of surgery for GERD.
In this procedure, a surgeon wraps the top of the stomach around the lower esophageal sphincter to tighten the muscle and prevent acid reflux.
Endoscopic Band Ligation
In an endoscopy, a surgeon passes an endoscope — a small, flexible tube with a camera — into the esophagus via the mouth. There are several types of endoscopic procedures and devices used to treat GERD:
Stretta: This procedure uses radiofrequency energy to tighten the muscles at the lower esophageal sphincter. It is the most common endoscopic procedure used to treat GERD in the United States.
EsophyX: The EsophyX device is used in a procedure called transoral incisionless fundoplication (TIF). It creates a new valve by folding stomach tissue around the esophagus and inserting small plastic fasteners to keep it in place.
Lynx: Using a Lynx device, the surgeon wraps a ring of tiny magnetic titanium beads around the area where the stomach and esophagus join. The ring allows food to pass into the stomach but keeps the area closed when no food is present.
Weight Loss Surgery
If you have obesity and GERD, your doctor may recommend weight loss, or bariatric, surgery to improve both conditions.
Various complementary therapies may help alleviate GERD. But, most need more research to confirm their safety and effectiveness in treating or preventing symptoms or healing damaged tissue.
Herbal Remedies
The following herbal remedies may help manage the heartburn that characterizes GERD:
Chamomile
Licorice
Ginger
Ginger can help if nausea is one of your symptoms, while chamomile can calm irritation in the digestive tract and improve your sleep. Licorice coats the esophagus and stomach and protects against irritation.
Other, less common, herbal remedies include:
Catnip
Fennel
Marshmallow root
Papaya tea
A review conducted in Korea and published in 2024 concluded that the following herbs, or ingredients in them, may also help manage GERD symptoms:
Crow dipper
Poria mushroom
Citrus unshiu peel
How Safe Are Herbal Remedies for GERD?
Herbal remedies, like medications, can have adverse effects and may interfere with other medications. Therefore, it’s essential to speak with your doctor before trying a herbal remedy.
“Herbal remedies lack FDA approval and oversight and have limited scientific data to support their overall efficacy,” says Carolyn Newberry, MD, a gastroenterologist at NewYork-Presbyterian Hospital / Weill Cornell Medical Center.
“While these remedies may be safe to try, you can’t tell how effective they will be, as the potency of such products is not regulated. Individual factors may also affect how useful the treatment is.”
Licorice-based products, for example, can be toxic.
“Licorice can have an effect on blood pressure and heart rhythms at high dosages and can interact with specific prescription medications including insulin, steroids, laxatives, and blood pressure medications,” warns Dr. Newberry.
Apple Cider Vinegar
Some people use apple cider vinegar to manage the symptoms of reflux, but there is no clear evidence to support its use and, at certain doses or formulations, it can be toxic and lead to further damage.
Breathing Exercises
Breathing techniques may help relieve GERD symptoms by improving how the lower esophageal sphincter, or anti-regurgitation barrier, works.
In a small 2021 study, people with GERD who practiced diaphragmatic breathing had fewer episodes of symptoms after two days than those who did not.
Acupuncture
Various studies have suggested that acupuncture may help manage GERD.
In an 8-week study published in 2024, 35 people with GERD took 20 mg of omeprazole per day, while another 35 had acupuncture every other day.
The overall effectiveness of both treatments was similar, but those receiving acupuncture had better scores when it came to quality of life and anxiety than the other group.
The researchers believe acupuncture may improve a “heart-stomach” connection, which regulates gastrointestinal hormones. The improved hormonal balance, they suggest, would improve the function of the lower esophageal sphincter, inhibiting reflux.
GERD treatments depend on the severity and frequency of symptoms, personal preference, and other factors.
Lifestyle measures to reduce reflux include dietary choices and stress management.
Fatty and spicy foods can worsen symptoms, while less acidic foods and whole-meal bread may be less likely to cause reflux.
Medications range from OTC treatments for mild symptoms to long-term medications that may also help the esophagus heal.
Surgery is an option if other treatments don’t help.
Various complementary therapies are available, but more research is needed to determine if they are safe and effective.
