GERD, or Gastroesophageal Reflux Disease, is a condition that causes the contents of the stomach to back up into the esophagus, causing heartburn, gas, sour breath and more. Sometimes GERD can be controlled by changes to diet and lifestyle, smoking cessation or stopping medications that cause GERD. In other cases, it is necessary to take medication to control GERD. It depends on the types of symptoms you have, how long those symptoms have been present, and a number of other factors.
The magnitude of GERD is huge. Almost 60 percent of the adult population will experience some type of gastroesophageal reflux disease (GERD) within a 12 month period and 20 to 30 percent will have weekly symptoms. There are approximately 64.6 million prescriptions written for GERD medications in the U.S. on an annual basis1.
Let's take a look at 7 things you should know about GERD medications:
1. Who needs GERD medications?
People who have heartburn almost every day. While heartburn is certainly a common symptom of GERD, it is not the only one. GERD sufferers can experience bloating, gas, a dry cough that interrupts sleep and other symptoms.
2. Medication is not the only recommendation.
GERD medication helps with symptoms, but it's important for a patient to make diet and lifestyle changes to avoid and/or eliminate triggers.
3. Some GERD medications are available OTC.
There are three subgroups of OTC (over-the-counter) GERD medications. One is the typical antacid, like TUMS, that neutralizes the acids in the stomach. The next is the H2 receptor blocker, like Zantac/Pepcid, that cuts down on acid secretion. The third is a stronger drug, like Prilosec OTC/Nexium 24 Hr, which shuts down acid secretion even more.
4. Some people may need prescription-strength GERD medications.
If OTC (over-the-counter) medications fail to provide relief, there are prescription doses available of the third type of drug, such as a prescription-strength Prilosec, Prevacid, Protonix, Dexilant, Zegerid, Nexium etc. These are prescribed when the OTC medications only provide partial relief, when the symptoms come back, or fail to improve. The strongest type of prescribed GERD medication is called a proton pump inhibitor, and prevents acid from being released into the stomach.
5. Your doctor will find the right prescription GERD medication for you.
There are many prescription-level medications available. A doctor will prescribe what he/she believes will work best for each individual case. The doctor must also consider which medications the patient's insurance plan will cover.
6. Sometimes there can be drug interactions with your GERD medication.
Because of the potential for drug interactions, it's imperative to tell your doctor about all other prescription and non-prescription drugs that are regularly taken. Some GERD drugs can decrease the concentrations of other medications, so it is crucial to reach medication reconciliation with the doctor. Amphetamines, anti-viral medications, osteoporosis medications, heart medications like blood thinners, and anti-anxiety medications are all prone to interactions with GERD medications.
7. You may need further testing if the GERD medications are not working.
When GERD medications aren't working, or development of alarm symptoms like inability to swallow, blood in vomiting, or weight loss, the doctor will recommend an Upper Endoscopy (also referred to as an EGD) to see what is going on in the stomach and esophagus. If the reflux symptoms are present for a long time, it can predispose the patient to develop pre-cancerous changes in the esophagus called Barrett's esophagus. People with obesity, a family history of esophageal cancer, and smokers are at an increased risk, so they should be screened to rule out damage.
1 Digestive Diseases Statistics for the United States – National Digestive Diseases Information Clearinghouse. (n.d.). Home – National Digestive Diseases Information Clearinghouse.