Therapy with histamine (H2) receptor antagonists should be considered first-line due to efficacy and safety.

For the treatment of GERD, American College of Gastroenterology guidelines recommend proton pump inhibitor (PPI) therapy initiated at once-a-day dosing before the first meal of the day.

Multiple PPIs have been recalled from the market due to safety issues.

Of the available medical options, H2 receptor agonist therapy is considered the most effective for both erosive and nonerosive GERD, based on multiple large-scale studies.