Also, avoid DRUGS that can cause or exacerbate reflux. NSAIDS or certain blood pressure drugs like calcium blockers can relax the lower esophageal sphincter and allow acid to get up in your esophagus. Also, any CNS active drug can lower sphincter pressure and worsen reflux -- opiates, antidepressants, anxiolytics, etc.
2) Weight loss WILL REDUCE REFLUX, BUT TAKES TIME and DEDICATION.
3) NOT EATING LATE and ELEVATING the head of your bed MIGHT reduce nocturnal sx via the effect of simple GRAVITY (I have a brick under each leg of my bed so my bed is elevated about 5 inches and does reduce nocturnal sx).
4) If you are still having sx more than a couple of times a week, then you may need a drug -- H2 Blockers like famotodine or ranitidine -- once or twice a day will prob take care of milder sx.
5) IF you STILL have frequent episodes, a PPI drug -- lke Nexium or omeprazole, etc. (which are now over-the-counter) -- MAY be needed for short courses, as there are probably some serious but pretty rare complications of chronic PPI therapy like renal disease, osteroporosis, B12 deficiency, magnesium deficiency, etc. But remember that bad reflux can lead to esophagitis, stricture (scarring of the esophagus that can BLOCK FOOD from getting into your stomach, GI bleeding, and esophageal cancer).
IF you STILL have bad reflux (i.e., bad or frequent sx most days of the week) have tried ALL of the lifestyle changes, and the drugs taken intermittently don't help optimally, then you are left with either of 2 options: DAILY PPI, which means taking a drug like omeprazole or Nexium every day;
seeing a surgeon and being evaluated for a NISSEN FUNDIPLICATION, where they go in and tighten the lower esophageal SPHINCTER to prevent acid getting up in your esophagus.
Personally, if I failed all else and still had frequent and bad sx, I would take DAILY PPI therapy -- Nexium, opeprazole, etc. -- and take preventative oral B12 and magnesium IF you will be on LONG-TERM PPI therapy.
IF you develop any SWALLOWING problems, you MUST see a GI specialist and have an UPPER ENDOSCOPY to r/o cancer or stricture and be MONITORED periodically for kidney problems, osteoporosis, B12 and mag deficiency, etc.