Things you should know (that your doctor may not be telling you) about GERD treatments.

Gastroesophageal reflux disease (GERD) is an abnormal passage of acid, digestive enzymes, and food from the stomach, back into the esophagus and even up into the upper airways and sinuses. It is a chronic condition that is the scourge of modern man. Once very rare, the rate of GERD is increasing by 30 percent per year of people having significant reflux symptoms. Overwhelmingly, healthcare professionals rely solely on acid suppression medications as their go-to therapies. Proton pump inhibitors (PPI) medications released in the early 1980s are used universally by gastroenterologists as their primary reflux therapy. Proton pump inhibitors are very helpful in controlling heartburn and healing ulcers in the esophagus but do not help with the symptoms of regurgitation and poorly control respiratory reflux symptoms. The symptoms of a chronic cough, chronic hoarseness, voice changes, feeling a lump in the throat, chronic sinusitis, otitis and tonsillitis in adults, dental enamel erosions, reactive airway disease, asthma, and pulmonary fibrosis all are related to reflux and are poorly treated by acid suppression through PPI medications alone.

Things you should know about PPI’s and Reflux Medication

Proton pump inhibitors (PPI) medications — omeprazole, lansoprazole, dexlansoprazole, rabeprazole, pantoprazole, esomeprazole — do not stop the potential for the progression of acid reflux disease, they simply manage the symptoms. Refluxed stomach contents may also contain bile; which research at the University of Rochester has found to be an underlying factor for Barrett’s esophagus and esophageal cancer.
PPI medications permit GERD sufferers to maintain the lifestyle and diet that created the GERD problems in the first place, without addressing the root cause of the reflux. Many experts believe the increase in symptoms of acid reflux, that affects nearly one in five American adults, is related to poor diet and the rate of obesity. PPI medications reduce or eliminate the symptoms of heartburn and acid reflux so that as long as the medications are used daily, there is no reason to work on fixing the underlying conditions that triggered the disease or would correct the problems.

Once beginning an effective regimen of PPI medications, it is difficult and painful to discontinue daily use — and this makes pharmaceutical companies happy! In fact, after just one month of daily prescription PPI medication use, your body can become dependent on them. Acid rebound effect or rebound acid hypersecretion (RAH) is a real condition that occurs when suddenly stopping PPI use. Since PPIs work by reducing the amount of acid produced by the stomach, once the medication is no longer present to tell the stomach not to produce gastric acid, it tends to overproduce the acid, causing extreme discomfort. This period of hypersecretion may last over one week. Since the pain is more severe than the normal GERD symptoms from hypersecretion of acid after stopping PPIs, those attempting to quit them give up and continue to take their PPI medication daily. One study tested healthy participants who had no history of GERD who took a daily dose of prescription PPI medication for eight weeks. Over 58 percent of the participants suffered severe reflux, indigestion, and heartburn.

Long-term daily use of PPIs is associated with many side effects and severe health risks. On the patient’s insert, the FDA has required these drugs to highlight the increased risk of c-diff colitis infections, malabsorption of calcium resulting in broken bones, and the malabsorption of magnesium leading to muscle and nerve dysfunction, and increased cardiac arrhythmia. In addition, research has discovered that those who take prescription PPIs had an increased risk of pneumonia, heart attacks, kidney failure, dementia, and several other serious conditions. A major study involving over 300,000 patients over five years showed a 50 percent mortality rate increase in PPI users and a 25 percent increased mortality rate in histamine 2 antagonist users (Pepcid and Zantac) as compared to equally ill patients who did not use antacid therapy.

It is imperative that GERD sufferers educate themselves on a GERD-friendly diet and lifestyle and try to take the safest medical regimen possible. There are no known side effects of over-the-counter antacids such as TUMS, Gaviscon, or Maalox. Pepcid and Zantac are safer than Nexium and Prilosec type drugs. Long-term therapy has multiple problems that are now being exposed. Please review the medical research associated with long-term complications of PPI medication use.