What is the gold standard initial treatment for GERD?

Proton pump inhibitors (PPIs) are considered the gold standard initial treatment for gastroesophageal reflux disease (GERD) due to their effectiveness in reducing gastric acid secretion. By inhibiting the proton pump in the stomach lining, PPIs significantly decrease the production of stomach acid, leading to reduced symptoms of heartburn, regurgitation, and esophagitis associated with GERD.

The effectiveness of PPIs extends beyond symptom relief; they promote healing of the esophageal mucosa and help prevent complications associated with chronic reflux. Studies have shown that PPIs provide superior acid suppression compared to other classes of medications, making them the first-line therapy in both the management and treatment of GERD.

Other options, such as antacids, histamine-2 receptor antagonists, and sucralfate, may provide relief, but they do not have the same potency or long-lasting effects as PPIs in managing the underlying cause of GERD. Antacids offer quick but short-term symptom relief, histamine-2 receptor antagonists are less effective in severe cases, and sucralfate is primarily used for its protective effects on the gastrointestinal lining rather than direct acid suppression.