GERD, or gastroesophageal reflux disease, affects more people than commonly thought. Some estimates of the number of people in the U.S. afflicted with GERD are as high as 35%. The market for GERD medications brings in $10 billion yearly. Yet while these GERD medications provide some temporary relief, they also have sometimes significant risks and side effects. These risks and side effects can become worse if you are an older adult or suffer from stress-related conditions like adrenal fatigue.
Healthcare providers typically recommend four different approaches to managing GERD. These approaches are:
The most common GERD symptom is a burning sensation in the stomach, back of the throat, or in the chest. It results from stomach acid leaking into the esophagus due to your lower esophageal sphincter not closing properly. In addition, at times the stomach acid can reach your mouth. And you may experience trouble swallowing, chest pain, and feel like you need to clear your throat a lot.
Moreover, GERD can affect more than just your esophagus. It can lead to inflammation of the pharynx (that part of your throat right behind your mouth) and your voice box or larynx. Likewise, it can lead to bronchitis, pneumonia, or asthma.
The goal of conventional remediation of this condition is an improvement of symptoms through GERD medications. Healthcare professionals delineate two categories of GERD medications. Firstly, those that decrease stomach acidity. Secondly, those that increase upper gastrointestinal tract motility.
These over-the-counter GERD medications work well for infrequent or intermittent episodes of the condition. However, continuous use may cause the problem to worsen. They pass through the stomach quickly, and your stomach may actually increase acid production as a result.
Histamine 2 (H2) blockers reduce the amount of acid produced in your stomach by slowing down the release of histamine. This hormone acts as the primary stimulus for acid production. Research shows this type of medication to work only slightly and to lead to tolerance in as little as two weeks. Therefore, people who take this type of GERD medication will quickly experience a reduced reaction to its dosage.
These GERD medications work to block the three major pathways of the production of stomach acid. Therefore, they prove more effective than H2 blockers. In addition, they also work to heal erosive esophagitis in a number of people, even those who experience severe damage.
However, despite their effectiveness at lowering stomach acid, these medications don’t address the anatomic difficulties underlying many cases of GERD.
Also, while PPIs appear safe and effective in the short term, research indicates potential significant problems when people continue this medication over a longer term. These potential long-term health risks prompted the federal Food and Drug Administration (FDA) to recommend their use for no more than three 14-day courses over a year.
Some of the potential long-term risks include:
One of the more serious potential risks of using PPIs concerns a vitamin B12 deficiency. This risk increases because prolonged use of these GERD medications leads to decreased stomach acid and malabsorption of vitamin B12.
The elderly already suffer from an increased risk of vitamin B12 deficiency. Those in this age range who take PPIs on a long-term basis increase this risk even further. Older people experience this type of deficiency due to problems with the enzymes and acids in the stomach and small intestine. Some of the symptoms of this deficiency include memory problems, lowered brain function, and neuropathy.
In addition, PPIs tend to inhibit the absorption of iron, magnesium, and calcium. As a result, some severe health issues can occur. These health issues may include increased incidence of bone fractures, increased risk of gastrointestinal issues, greater risk of cardiovascular problems that can lead to heart attack or stroke, and even greater risk of death.
Those who experience stress or increased inflammation are also at a higher risk of problems developing from GERD medications. Stress that is ongoing frequently leads to a common condition known as Adrenal Fatigue Syndrome (AFS), in which your adrenals become unable to produce enough cortisol, the stress hormone, to meet demand.
If you suffer from AFS, a large number of your body functions will slow down in an effort to conserve energy. This includes your detoxification system, reducing your body's ability to rid itself of toxins.
Detoxification falls under the NeuroEndoMetabolic (NEM) stress response. The NEM model consists of six circuits containing three organs or systems each that form your body’s global stress response mechanism. These circuits work in an inter-related fashion in that what affects one will affect others as well. The Detoxification circuit is one of these, involving your liver, immune system, and extracellular matrix, or the fluid between your cells.
With the Detoxification circuit slowed, the body does not deal effectively with toxins and metabolic by-products. Among these by-products are leftover materials from the breakdown of medications, including GERD medications. This increases the body’s toxin load and can trigger inflammation.
Inflammation comes with your body’s reaction to stress from any source. Clinical research shows a close relationship between inflammation, stress, and your microbiome.
Your microbiome plays a large role in your overall health. When stress becomes chronic, your microbiome suffers greatly. The balance between healthy and harmful bacteria there becomes fragile, with unhealthy bacteria multiplying rapidly.
Stress also affects the lining of your gut that prevents these unhealthy bacteria along with other pathogens from gaining access to your bloodstream. With chronic stress, this lining weakens, allowing bacteria and pathogens to get into your bloodstream. This triggers your immune system to attack these foreign invaders. As a result, inflammation increases in an effort to destroy the harmful pathogens.
Long-term use of GERD medications and the resulting deficiency in vitamin B12 added to an already compromised gut can lead to significant consequences, particularly in regard to how you deal with inflammation. Consequently, inflammation will increase, increasing the potential of developing a number of health conditions.
The typical GERD medications can control heartburn by reducing acid production, but they don’t change the amount of reflux. As a result, you will continue to experience symptoms like difficulty swallowing, chronic respiratory problems, and regurgitation.
In addition, if you stop the medications, your symptoms can reappear. Therefore, dependence on these medications can occur. And, you may develop a tolerance for the dosage, requiring larger doses or more powerful medications.
If medications become ineffective, other therapy includes surgery of two kinds. Firstly, transoral incisionless fundoplication (TIF) describes a procedure in which a special device creates a passageway for an endoscope. Your surgeon then uses preloaded tweezers and fasteners to repair or recreate your lower esophageal sphincter.
TIF leads to shorter recovery time, less pain, and shorter time for the procedure.
The other option, Nissen fundoplication, involves your surgeon wrapping the upper part of your stomach around the lower part of your esophagus. It increases the reflux barrier and may bring permanent relief for GERD. Your surgeon can do this procedure either laparoscopically or through a complete incision.
If you are already significantly overweight, you may also get some relief from bariatric surgery to lose weight. Gastric bypass surgery will often bring relief from GERD symptoms.
Natural remedies for GERD can also lead to significant relief without the potential risks and side effects. Most importantly, these natural remedies make up the first step in dealing with GERD in many care plans.
Making the following changes in your diet can greatly benefit you if you suffer from GERD.
With the increasing frequency of GERD and the continual advertising concerning medical treatments for the symptoms, the use of GERD medications increases dramatically. The use of these medications does bring relief, and sometimes significant relief. However, drawbacks to their use in the form of risks and side effects exist.
One of the major drawbacks to these medications involves the necessity of their use potentially for the rest of your life. This is because if you stop these medications, symptoms often return.
In general, GERD medications result in few side effects in the short term. However, research shows long-term implications for serious side effects.
Lifestyle and dietary changes should be the first choice in the remediation of GERD symptoms. These changes do not result in the same risks and side effects as do medications.
If you are older or suffer from AFS, the potential for serious side effects increases. Above all, the likelihood of a deficiency of vitamin B12 increases, which can lead to more serious long-term problems.
If you are suffering from GERD and the side effects of GERD medications, here are a few things you can do to alleviate the situation.
Whichever option you decide to take, however, please do so with the guidance of your healthcare provider who can help you decide about the risks and side effects of your choices.
If you want to know more about or need assistance with GERD medications, the team at Dr. Lam Coaching can help. We offer a free** no-obligation phone consultation at +1 (626) 571-1234 where we will discuss your symptoms and various options. You can also send us a question through our Ask The Doctor system by clicking here.
While GERD medications can bring sometimes significant relief, and their short-term use brings few side effects, long-term use of these medications can lead to serious problems. One potential problem of special concern to people who are older or suffer from AFS involves a deficiency of vitamin B12.