What is the standard first-line medication for managing GERD?

Proton pump inhibitors (PPIs) are considered the standard first-line medication for managing gastroesophageal reflux disease (GERD) due to their effectiveness in reducing gastric acid secretion. By inhibiting the proton pump in the stomach lining, PPIs significantly lower the production of stomach acid, which helps alleviate the symptoms of GERD, such as heartburn and regurgitation.

Moreover, PPIs have been shown to promote healing of the esophagus and prevent complications associated with chronic acid exposure, such as esophagitis. This mechanism addresses the underlying cause of GERD more effectively than other treatment options.

Although H2 receptor antagonists and antacids can provide symptomatic relief and are sometimes used in conjunction with PPIs or for mild cases of GERD, they do not reduce acid secretion as profoundly or have the same level of efficacy for long-term management. Prokinetic agents can enhance gastrointestinal motility but are not primarily utilized for acid suppression and may have side effects limiting their use. Therefore, for comprehensive management of GERD, PPIs are recognized as the first-line approach.