GERD: What you need to know about medications
If you have been diagnosed with gastroesophageal reflux disease (GERD), you’ve likely heard of or are currently taking a proton pump inhibitor (PPI). These are sold under several brand names, including Nexium and Prilosec. GERD is characterized by acid backing up into the esophagus from the stomach. PPIs reduce acids in the stomach, minimizing or preventing the heartburn, coughing, and other symptoms associated with GERD.
If a PPI is working well for you, you may wonder why you can’t just keep taking it indefinitely. But stopping the production of stomach acid can trigger other problems. In recent years, the Food and Drug Administration has issued numerous warnings about PPIs. Long-term PPI use may be associated with an increased risk of bone fractures, hard-to-treat infections, kidney damage, pneumonia, and other conditions.
That’s why PPIs are usually only recommended for three to 12 weeks, though individual cases may vary. Be sure to follow your doctor’s recommendation, and let him or her know if you’re taking an over-the counter PPI that wasn’t prescribed. Always talk with your doctor before you stop taking any prescribed medication.
What works to ease long-term GERD symptoms
If you can’t take a PPI for more than 12 weeks, what can you do to get relief from your reflux?
Lose weight.
If you’re overweight, losing weight is the first thing most doctors will recommend. Excess stomach fat puts pressure on your abdomen and pushes gastric juices into your esophagus. Losing 10 percent of your body weight can make a big difference in relieving GERD symptoms.
Quit smoking.
Some studies have found that nicotine can relax the muscles in the esophagus, and it can interfere with your saliva’s ability to clear acid out of your esophagus.
Avoid trigger foods.
Your diet can play a role in GERD. Foods that may cause symptoms include:
- Carbonated drinks.
- Citrus foods (including fruit juices).
- Coffee (you may be able to have one or two cups).
- Fatty foods.
- Garlic
- Mints (especially peppermint).
- Alcohol
When to get an endoscopy
Chronic GERD can cause precancerous changes in cells. Many people with GERD are prescribed an upper endoscopy to rule out these conditions. During an endoscopy, your doctor will insert a long, flexible tube down your throat, into your esophagus. A tiny camera on the end of the tube will allow your doctor to examine your esophagus, your stomach, and the beginning of your small intestine.
Here are some things to keep in mind:
- Your doctor may recommend an endoscopy if you still have GERD symptoms after taking a PPI for four to eight weeks, especially if you have GERD symptoms and difficulty swallowing, significant weight loss, gastrointestinal bleeding, or anemia.
- If you respond well to PPIs and don’t have any additional symptoms, your doctor probably won’t recommend an endoscopy (especially if you are a male under 50 or a female of any age, as the risk of cancer is low). The results are unlikely to provide any information that would change your treatment. Plus, the procedure requires sedation and carries minor risks, as well as out-of-pocket costs.
The best strategy for managing GERD—and putting your mind at ease—is to make lifestyle changes that will address the cause of your GERD symptoms. Ask your doctor for a Prescription for Wellness, in which your doctor will prescribe one of our health coaching programs to help you lose weight, quit smoking, or avoid foods that trigger GERD symptoms. There’s no cost to you for health coaching. Sessions take place over the phone at a time that’s convenient for you. You can contact a health coach today by calling 1-866-778-6073.
Sources:
www.health.harvard.edu/diseases-and-conditions/chronic-heartburn-do-you-need-an-endoscopy
www.uspharmacist.com/article/proton-pump-inhibitors-considerations-with-longterm-use
www.gastro.org/info_for_patients/gerd-107-long-term-use-of-proton-pump-inhibitors-ppis#GERD
