What is the first-line treatment for GERD?

The first-line treatment for gastroesophageal reflux disease (GERD) is H2 blockers followed by the use of proton pump inhibitors (PPIs) if the initial therapy is ineffective. H2 blockers, such as ranitidine or famotidine, work by reducing the production of stomach acid, which can help alleviate symptoms of GERD such as heartburn and regurgitation. If H2 blockers do not provide sufficient symptom relief, healthcare providers may then prescribe PPIs like omeprazole or lansoprazole, which are more potent and provide longer-lasting acid suppression.

The rationale for starting with H2 blockers is to manage mild to moderate GERD symptoms effectively while also potentially avoiding more aggressive treatments unless absolutely necessary. The step-up approach in treatment emphasizes the need to tailor therapy based on the patient's response to the initial medication, ensuring a more individualized treatment plan.

While antacids may provide short-term relief for occasional heartburn, they do not address the underlying processes causing GERD. Surgical options are typically reserved for patients with severe GERD who do not respond to medication or who prefer surgery to manage their condition. Dietary changes can be beneficial and are often recommended as part of a comprehensive treatment plan, but they are usually not adequate as