Johns Hopkins Health Alert
Should You Take GERD Medication Over the Long Term?
If you have gastroesophageal reflux disease (GERD) and take medication to control your symptoms, you're probably wondering what the long-term effects are. In this article Dr. Sergey V. Kantsevoy and his team of gastroenterologists at Johns Hopkins answer the question: What are the risks of taking reflux medication over the long term?
The contents of your stomach are emptied into the small intestine, but sometimes they flow backwards into your esophagus. This phenomenon, known as gastroesophageal reflux, happens to everyone from time to time. It usually produces no symptoms other than occasional heartburn -- a burning sensation behind the breastbone. When gastroesophageal reflux occurs frequently, however, you may begin to experience significant discomfort related to the acid reflux -- then, it is considered gastroesophageal reflux disease (GERD).
GERD is a serious condition because the acid and digestive enzymes from the stomach can damage tissues in the esophagus as well as in adjacent organs such as the mouth, pharynx (throat), larynx (voice box), trachea (windpipe), and lungs.
Medications for GERD like proton pump inhibitors and H2-blockers are generally very safe. But as with any drugs, their beneficial effects are often offset by some negative consequences. The most serious potential complications of GERD medication result from the reduction of stomach acid that actually protects your body from bacteria and viruses that may be present in food. Without sufficient acid levels, stomach bacteria are allowed to grow—and travel up or down the digestive tract.
For example, there’s a small chance that stomach bacteria may enter your trachea and upper airways, resulting in pneumonia. Or you may not have enough acid to fight off a serious intestinal infection from a bacterium like Clostridium difficile (C. difficile), which causes colitis, diarrhea, and cramps. Your body also needs stomach acid to help digest vitamin B12. Without sufficient levels of stomach acid, you could develop low vitamin B12 levels and, subsequently, anemia.
Bottom line advice on GERD medications: All of these potential complications are rare and treatable, so for most people, taking GERD medication does more good than harm -- especially if you have esophagitis or Barrett’s esophagus. If your GERD isn’t severe, talk with your doctor about taking your medication as needed, rather than continuously.
Posted in Digestive Health on September 1, 2008
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As the doctor states:
"But as with any drugs, their beneficial effects are often offset by some negative consequences."
He is giving examples of the gastrointestinal side effects. A new study was just released Friday on the links between common treatments for indigestion, and low bone density, but since this alert came out on Labor Day, I am sure it was in line for publication on the holiday prior to that set of study results being released.
Clearly all patients should be aware of the potential side effects of every pill they take, from prescription, to over the counter medications, to vitamin pills. And particularly in view of their own health history.
If you have not already created a family health history, you can do so on line at https://familyhistory.hhs.gov/
If you don't want to enter any personal information into the computer, then download the sample PDF to have a look at the kinds of information you might like to include.
One should also keep a list of all medications and vitamins and supplements they take, and keep the list updated, so you can work with your doctor proactively.
Posted by: Jo | September 2, 2008 8:56 AM
I have suffered from GERD for about 6-7 years and it complicates/relates to my diagnoses of Asthma, chronic bronchitis and emphysema. I have been on protonix for about the same time. I was diagnosed with osteoporosis 2.5 years ago (though through meds and exercise, my bone density improved). I am concerned about getting osteoporosis again if my health fails and I can no longer do the exercise regime I now do. I read the research relating proton pump inhibitors with osteoporosis and am concerned about how to treat my GERD and not impair my calcium absorption (presumably due to lack of stomach acid).
Are there other options besides proton pump inhibitors and H2 blockers (which were tried but not successful before my placement on protonix)?
Posted by: SeEttaMoss | September 8, 2008 2:51 AM
I assure you this medication is harmful over the long term. I have been takig Prilosec for about 5 yrs and decided to come off it after developing the same kind of pain experienced before I started taking it. I also had this great sense of fullness occasionally that was very uncomfortable. I Googled this subject and was surprised at how many people have the same side effects. I am now taking DGL before I eat, aloe juice twice a day. I started keeping a food diary of what foods do and do not cause indigestion. As you can probably guess the main culprit is processed foods, so I am now making most of my own meals, or sticking to a protein and vegetable combo and not mixing in carbs. I will have carbs with vegetables, but no protein. So far it is working and what a great relief. Still have to take Pepcid every few days, as I have only been on this program for a month. Believe me, if I can get to the point where this can be controlled with diet and natural supplements I will NEVER take this type medication again.
Posted by: FayeNelson | February 18, 2009 11:59 AM
It is of great concern that FDA has an alert ,that over extended usage of proton pump inhibitors can cause a low magnesium level. After doing some research and I personally am unsure that my magnesium level is low, I have had other tests done due to spasms under the right rib cage and center abdomen of which cannot be explained. All testing inclusive are the following.> gall bladder ultra sound, barium upper and lower pelvic, HIDA Scan/Kinevacs are all negative including Hypylori and all bloodwork and liver/kidney perfect. Since everything is negative, I have stopped cimetidine which I have taken off and on for quite some time and the spasms seem to be alleviating somewhat. Hopefully if the spasms are due to the above, I am greatly appreciative to receiving that alert and any that John Hopkins gives on this area.
Posted by: jhdme10 | March 5, 2011 10:16 PM
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I have also seen reports (though I have not read any original papers) that the reduction of stomach acid resulting from long-term use of GERD-reducing medications can hinder dissolution and adsorption of calcium, especially that taken in supplement form.
Additionally, some researchers have urged long-term users of such medications to make sure they have received the pneumonia vaccine, given the potential for reduced protection against pathogens in the stomach.
Having both serious GERD and a parent whose death was likely related to GERD, I am taking omeprazole daily and remain concerned about potential side effects.
Posted by: JonK | September 1, 2008 9:22 AM