GERD treatment online: PPIs, H2 blockers, and lifestyle
Acid reflux affects ~20% of US adults regularly. Most cases respond to lifestyle modification plus an OTC or prescription acid suppressant. Telehealth handles routine GERD management and can escalate to GI referral when needed (red-flag symptoms or refractory cases).
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OTC foundation
Famotidine (Pepcid) for as-needed relief. Omeprazole (Prilosec) and esomeprazole (Nexium) — OTC at lower doses, prescription at higher doses. Effective for daily acid suppression. Take 30-60 minutes before first meal.
Prescription escalation
Higher-dose PPIs (omeprazole 40mg, pantoprazole, dexlansoprazole 60mg) for refractory symptoms. Sucralfate for esophagitis. Baclofen and metoclopramide for select cases. Telehealth-prescribable.
Lifestyle interventions that work
Weight loss (single highest-impact change for overweight patients). Elevating head of bed 6+ inches. Avoiding trigger foods (caffeine, alcohol, chocolate, citrus, peppermint, fatty foods). Not eating within 3 hours of bedtime. Sleeping on left side.
Red flags requiring GI referral
Difficulty swallowing, unintentional weight loss, vomiting blood, black/bloody stool, anemia, age >55 with new-onset symptoms, family history of esophageal cancer. Telehealth platforms should screen for these and refer out.