Johns Hopkins Health Alert
Pros and Cons of Daily Medication for GERD
Gastroesophageal reflux disease (GERD) is a chronic condition, which means that it requires a long-term strategy. For many people, the recommended treatment for frequent heartburn is taking a daily medication indefinitely, a regimen known as continuous maintenance therapy. The goal is to prevent a relapse of GERD symptoms. It is a good idea to stop taking your acid blocker when you don’t have symptoms? Here’s advice from Johns Hopkins.
Many people with gastroesophageal reflux disease (GERD) resist taking daily medication. Factors like high cost, safety concerns, and inconvenience sway individuals to try a less frequent form of drug therapy, even without their doctor's approval. Studies show that 20 to 29% of individuals prescribed proton pump inhibitors for gastroesophageal reflux disease (GERD) take their medication less often than instructed by their physician, and 79% do not refill their prescriptions as often as they should to comply with the dosing instructions provided by the manufacturer.
Thus, it appears that many people with gastroesophageal reflux disease (GERD) are willing to risk total symptom relief for reduced medication use. But do the benefits outweigh the risks?
Pros and Cons to Consider: Although acid blockers are very safe and are generally associated with only minor side effects, they do reduce stomach acid, which is one of your body's defenses against infection. When taking an acid blocker for gastroesophageal reflux disease (GERD), bacteria that would normally be killed off by stomach acid may now thrive. If bacteria-containing stomach juice refluxes into the trachea and upper airways, it can lead to pneumonia.
Taking acid blockers long term for gastroesophageal reflux disease (GERD) can also deplete your body of vitamin B12, as stomach acid is necessary for the proper digestion of this important vitamin. If you're on continuous therapy for gastroesophageal reflux disease (GERD), you may need a monthly B12 injection.
Perhaps one of the biggest drawbacks to taking long-term medication for gastroesophageal reflux disease (GERD) is the cost. One month's supply of a proton pump inhibitor can cost between $110 and $140. Name-brand H2- blockers cost between $100 and $230 every month, while generics are available for $10 to $52 for a monthly supply.
Nonetheless, for most people with gastroesophageal reflux disease (GERD), the benefits of medication far outweigh the cost and minor risks. For instance, people with more serious disorders that can result from uncontrolled gastroesophageal reflux disease (GERD) like Barrett's esophagus (an abnormal lining of the esophagus that can be associated with the development of cancer) or severe esophagitis (inflammation of the esophagus) require continuous treatment with acid blockers to prevent a relapse of symptoms and to avoid further damage to the esophagus.
Posted in Digestive Health on February 8, 2010
Reviewed January 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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I'm a 68 year old male I remember well the difficulties at the beginning. At my most recent endoscopy the doc said "keep taking the daily Rx" At first we tried many drugs (10 yrs ago) then Nexium which I have taken for 7 years. I know it is name brand expensive but it's worth it. Of course I changed my diet, but it wasn't difficult as I don't drink, smoke, and am vegetarian. I feel great, have never stopped taking it because I remember the consequences and believe the doctor when he tells me the benefits he is seeing.
Posted by: Freddie41 | February 13, 2010 9:34 AM
I am taking omeprazole (Prilozec) daily for GERD, and it seems to be generally effective in controlling reflux, although from time to time I have difficulty swallowing. But another symptom has popped up (after being on an antibiotic for 10 days for other reasons): Upon burping I get a slight pain in the central chest and oppositely located in the back. This has persisted, although perhaps less intensive, despite taking the medication for about three months. Question: Is this a common symptom, and of what? Note: This is uncorrelated with physical activity.
Posted by: mkb29 | February 13, 2010 12:35 PM
I cured myself of GERD: I had GERD for about 3 years and suffered a lot. I tried Nexium, Prilosec, Tagamet antacids galore and so on. Raised the head of my bed and everything else, but nothing worked, and my symptoms continued. I even had an esophageal endoscopy, which required going under with general anesthesia. They couldn't find my problem, but the symptoms continued.
Then I stumbled on the remedy for GERD, almost by accident. The acid reducers and other medications did not work, but instead create a negative digestive feedback loop between the small intestine and the stomach. Reducing the acid does not help or get rid of the problem. Once you understand that the problem is not stomach acid, but digestion, you are on your way to getting rid of GERD once and for all.
Here is how I did it: I used probiotics and aloe vera juice mainly to solve my problem. Specifically, I used Fast Balance GI and MegaProbiotics ND probiotics formulas, made by FoodScience of Vermont, along with Aloe Vera Juice to heal my irritated GI tract. For the first 2 months, I also used a natural antacid called "Alka Fizz", but after a few weeks, I got better finally and did not need to take the Aloe Vera Juice or AlkaFizz.
The key thing is the probiotics or friendly bacteria. I believe my GERD started when my doctor scripted me a 5 day Z pack (Zithromax) a super strong antibiotic also wiped out the good bacteria in my small and large intestine, impairing proper digestion. This created the negative digestive feedback loop between my small intestine and stomach, BECAUSE THE FOOD WAS NOT BREAKING DOWN PROPERLY. Once I resupplied my GI tract with healthy, friendly bacteria, I was able to stop using Nexium, Prilosec, Tagamet and all those products. At this point, I have been GERD free for about 2 or 3 years now.
Posted by: walk_the_walk | February 13, 2010 5:49 PM
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I am a long time user of Prilosec for GERD. The biggest problem with this drug (and related drugs) is not the cost, inconvenience, etc., but rather the difficulty in discontinuation of the drug--there is a huge problem with rebound symptoms of GERD. I have tried several times to stop the medication--with same result each time. It may or may not be a return of original symptoms--the argument against return of symptoms: studies I have read about that found a similar result with normal, non-GERD patients after a month or so of the drug. I would love to read more about this phenomena, and hope that JH will help here. I also would love to stop the drug--not at all a fan of long-term medication use, unless strictly necessary.
Posted by: carcie | February 8, 2010 7:15 AM