Depending on the severity of your symptoms, your clinician may recommend a step-up approach or a step-down approach for treating the symptoms of GERD.
A step-up treatment approach involves starting with a low dose of medication, then raising it until symptoms stop. For example, a clinician might prescribe a low-dose H2RA, then raise the dose, then prescribe a low-dose PPI.
A step-down approach starts with a higher dose of medication, which is then lowered as long as symptoms are still controlled. For example, a clinician might prescribe a standard PPI dose, then an H2RA.
If you have mild acid reflux (GERD) symptoms like heartburn and regurgitation less than once a week, you may get temporary relief from taking an antacid. These over-the-counter (OTC) medications can begin to work in 5 minutes and last up to an hour, but they don't cure GERD. Sodium alginate is another OTC medication that can offer short-acting acid reflux symptom relief. These medications can be used at the same time as prescription medications.