​Are your anti-reflux meds not working? Get yourself OUT of the GERD Treatment Gap.

Though many people may look to anti-reflux medications as a silver bullet to cure their acid reflux symptoms, some are really disappointed to discover that these popular medications simply do not work for them. In fact, 30% of people still experience persistent acid reflux symptoms despite taking proton pump inhibitors (PPIs) daily 1. Nighttime symptoms seem to be especially difficult to control with these medications as over 70% of GERD patients on PPIs continue to experience moderate to severe nighttime breakthrough symptoms 2 .

If you have tried PPI medications without much relief, you are clearly not alone! You are probably considered one of the many Refractory GERD patients who show an “incomplete or complete lack of response” to PPI therapy. 3 This large group is often the most difficult for doctors to treat because there is a lack of effective treatment options causing patients, such as yourself, to fall into what has been called the GERD Treatment Gap 4.

Who typically falls in the Gap?

While doctors struggle to predict exactly who will be PPI-Refractory, there do seem to be some trends. Studies show that certain patients are more likely to be unresponsive (partially or completely) to PPIs if they suffer with:

  • Indigestion (dyspepsia) 5
  • Regurgitation6
  • Atypical symptoms such as cough, chest pain or sleep disturbances 7
  • Non-erosive reflux disease (NERD) 8

For patients who continue to suffer with nighttime symptoms, they often wonder if surgery might help. Studies actually show that surgery, such as laparoscopic fundoplication, is less effective for Refractory GERD patients than for those patients who are responsive to PPI medications. 9

How can you get out of the Gap?

So, medications don’t work and surgery is unlikely, what about lifestyle modifications? The only two clinically proven lifestyle changes to be effective for the majority of people are weight loss and sleep positioning. While weight loss, if necessary, can take some time, sleep positioning can bring almost immediate relief.

A recent study by Cleveland Clinic studied the effectiveness of sleep positioning specifically with Refractory GERD patients. The study, “Use of a Sleep Positioning Device Significantly Improves Nocturnal Gastroesophageal Reflux," 10 used the MedCline Reflux Relief System with patients who had nighttime reflux symptoms despite daily PPI usage. Study participants were asked to sleep on MedCline for 2 weeks.

Using MedCline, Refractory GERD patients reported a:

  • 72% reduction in nighttime GERD symptoms
  • 65% reduction in the morning impact of GERD
  • 62% reduction in overall concerns about nocturnal GERD

Finally, a new relief option for those who are PPI-refractory

Refractory GERD presents a significant challenge for both doctors and those suffering nightly with distressing acid reflux symptoms. MedCline offers an effective, natural solution for those who are unable to or wish to avoid long-term usage of PPI medications.


[1] S, Johnson DA, Stålhammar NO, Zerbib F.Brook RA, et al. Burden of gastro-oesophageal Toghanian reflux disease in patients with persistent and intense symptoms despite proton pump inhibitor therapy: A post hoc analysis of the 2007 national health and wellness survey. Clin Drug Investig. 2011 Oct 1;31(10):703-15.

[2] Chey WD, Mody RR, Wu EQ, et al. Treatment patterns and symptom control in patients with GERD: US community-based survey. Curr Med Res Opin. 2009;25:1869-78.

[3] Fass R, Gasiorowska A. Refractory GERD: What is it? Curr Gastroenterol Rep 2008; 10: 252–257.

[4] Subramanian, Charumathi Raghu, Triadafilopoulos, George. Refractory gastroesophageal reflux disease. Gastroenterology Report (2014) 1–13, doi:10.1093/gastro/gou061.

[5] Kahrilas PJ, Howden CW, Hughes N. Response of regurgitation to proton pump inhibitor therapy in clinical trials of gastroesophageal reflux disease. Am J Gastroenterol. 2011;106:1419-1425.

[6] Kahrilas PJ, Howden CW, Hughes N. Response of regurgitation to proton pump inhibitor therapy in clinical trials of gastroesophageal reflux disease. Am J Gastroenterol. 2011;106:1419-1425.

[7] Dickman R, Boaz M, Aizic S, et al. Comparison of clinical characteristics of patients with gastroesophageal reflux disease who failed proton pump inhibitor therapy versus those who fully responded. J Neurogastroenterol Motil 2011; 17:387–394.

[8] Bytzer P, van Zanten SV, Mattsson H, Wernersson B. Partial symptomresponse to proton pump inhibitors in patients with nonerosive reflux disease or reflux oesophagitis – a post hoc analysis of 5796 patients. Aliment Pharmacol Ther 2012; 36:635–643.

[9] Lundell L. Surgical therapy of gastro-oesophageal reflux disease. Best Pract Res Clin Gastroenterol. 2010;24:947-959.

[10] Allampati, S., Lopez, R., Thota, PN., Ray, M., Birgisson, S., Gabbard, SL..Use of a Sleep Positioning Device Significantly Improves Nocturnal Gastroesophageal Reflux Symptoms. Dis Esophagus. 2016 Sep 15. doi: 10.1111/dote.12495148, Issue 4, Supplement 1, Page S-617.