An irony is that PPIs as well as H2 blockers don’t have any effect on reflux per se. They merely reduce the esophageal acid exposure due to reflux. They also don’t impact esophageal Pepsi exposure, which itself may be involved in symptom production.
The only known drug to actually reduce reflux itself is baclofen. But baclofen has its own rather intense side effect profile.
For very severe cases recalcitrant to medicine, there is a new surgical procedure called EndoStim.
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