I did a month's course of Omeprazole in the morning and Pepcid before going to bed. It got much better, and now I rarely have to take something. Before that, I was taking sodium bicarbonate every day, which is apparently bad for you and can worsen the symptoms over time.

Losing weight has significantly reduced my symptoms (my symptoms are pretty unambiguously down to a hiatal hernia). If you haven't, you may also want to get tested for H. Pylori.

Depending on what kind of pill you take you might want to try an alternative. E.g. ranitidine vs omeprazole or other proton-pump inhibitor.

But I presume you've seen a doctor? Because there are some really serious issues that can also trigger it and suppressing the symptoms can mask issues like stomach cancers so you don't want to self-medicate without at least checking with a doctor first.

Yep, like someone else mentioned, mine wasn't classic symptoms but throat and sinus issues. He prescribed pantoprazole but said I could stop taking it after a while. I've found that not to be the case.

He also said it was odd to have it at my age and weight but I've since found others in my family have it as well, so maybe genetic?

I shared my experience above (https://news.ycombinator.com/item?id=36060204).

This improvement for me has been really recent. Maybe it helps you too. Good luck!

Exercise/weight loss or a diet change seem to be common fixes.

Laying off of greasy foods has helped immensely for me. Reducing alcohol (as you mentioned) has also been a minor improvement, though definitely not as much as what I mentioned prior.

I've been on and off Omeprazole, which helps immensely but makes me paranoid about long term effects (like a decade+ - I'm in my 30's).

One thing that has helped a ton is Gaviscon Advance imported from the EU, which contains Sodium Alginate. This was recommended to me by a GI specialist at MGH; the sodium alginate floats to the top of the stomach and forms a sort of physical barrier for a few hours to prevent acid from coming up (alongside other antacids like you'd find in tums). For reasons I don't understand almost nothing is marketed in the US containing it.

The tablets like these (https://www.amazon.com/gp/product/B08GCN88WX/) are honestly pretty palatable - I chew them a couple times and then wash down with water, and it avoids some of the gumminess reviewers describe.

There's also a liquid that I think might find a bit more effective, but less palatable and convenient on-the-go (https://www.amazon.com/Gaviscon-Advance-Aniseed-500/dp/B01N4...).

In the US I was recommended this: https://refluxgourmet.com/ and have to say it worked reasonably well for me.

I'll second the sodium alginate.

It forms a raft which physically stops the acid from rushing up.

I use life extensions esophageal guardian, which are chewable tablets. (Don't confuse it with esophacool, which is just an anti-acid)

If you experience dramatically worse symptoms at night when attempting to sleep and therefore laying down flat, first: sleep on your left side. Due to the physics/geometry of the esophagus, sleeping with your left side facing down is the most helpful in terms of preventing acid from being able to work its way up the esophagus. Don't quite get why, but it just works.

Second, investing in a full length bed wedge that goes either under your mattress (and extends the entire length of the mattress from head to foot) or the same but as a memory foam topper, it really does alleviate the night time unable to sleep problem. I used one made by Avana comfort with a ton of success. The partial bed wedges or pillow bed wedges are too uncomfortable for me personally but the ones that go from head to foot at a gradual gentle incline are fine.

Figuring out dietary triggers is also a huge factor for many.

For me, I discovered if I eat any tomato at all, even tiny pieces - I will have acid reflux symptoms for like at least 12 hours. So I just don't it anymore except at a rate 11am lunch and even then I still often suffer.

For me, cutting out coffee is the other biggest solution, but I'm an addict and can't stop permanently, but I've found that cold brew (NOT hot brew over ice - aka many 'iced coffee' methods) - with specifically those labeled Dark Roast - to be the least aggravating (because both the cold brew extraction method and the darker roasts have a lower amount of acidity) and adding milk to make it less harsh as well, for me I do a 1:1 ratio between cold brew and almond milk, and finally only drinking it first thing in the morning as soon as possible after a breakfast, is fine.

I don't need the bed elevator/wedge if I follow my proper dietary alterations (barring certain late night alcohol situations).

Sleeping on my left side is what really helped me.

The esophagus approaches the stomach from the right side, then hooks in to meet it. When you sleep on your right side, and the sphincter muscle is weak, the fluid just goes down like a drain. When you sleep on your left side, even if the muscle is weak, the fluid would need to go up, or the stomach be entirely full, to get into the esophagus.

Pictures to aid understanding: https://www.google.com/search?q=esophagus+stomach&tbm=isch

I had unbearably bad heartburn for years, especially at night, which made it difficult to sleep.

I started avoiding trigger foods like dark chocolate and started front-loading my meals earlier in the day. Still drink lots of coffee.

I now have my final meal about 4.5+ hours before bed, and it's usually small.

My new routine became habit and all symptoms and suffering completely disappeared. And it's not like my body changed, because if I do eat too late, I get bad heartburn like I always have.

Speak to a specialist about the Stretta procedure. Application of RF energy to the lower esophageal sphincter in a short outpatient procedure. More effective than PPIs, but less so than fundoplication, which is much more invasive and permanent.

My experience fwiw:

A wedge pillow helped a little. Keeping some alkaline water at my bedside to sip helped more. These were to ameliorate the symptoms to give my body a chance to heal on its own (over a few weeks). I didn't want to take omeprazole, and without these ameliorations I might've been driven to that. I followed a carnivore diet.

How did you jump off the topic? You asked a question that the exercise described above is designed to solve. There is no other known solution if you have a failing LES.

Do you drink coffee or some other caffeinated beverage? For me, caffeine is THE trigger for reflux. Secondary trigger is portion size. If I don't drink caffeine and I keep my meals relatively small I'm generally fine.

That could be it. My mom had reflux and had to stop coffee. I'm pretty hooked though. I guess I should try stopping.

I got rid of my reflux by entirely cutting alcohol. It took me a while to figure it out because merely reducing consumption was not enough.