By: Jean Johnson for Reflux1There’s a good reason to tell the doctor who is treating your reflux about all the medications you are taking. While the gastrointestinal tract is an amazingly well-designed system, when it’s subjected to various stresses including the effects of certain medications, its function can become compromised.
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Symptoms for GERD can include:
A burning pain in the center of the chest under the breastbone – also called heartburn – along with regurgitation and nausea.
Symptoms of heartburn can start high up in the abdomen and extend clear into the neck, mimicking heart pain. The pain may be more sharp and pressure-like as opposed to burning, and in some people, the discomfort can extend around to the back.
If an especially severe attack of reflux occurs after eating, a person can feel as though they have difficulty swallowing and even experience some shortness of breath along with anxiety.
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“We’d just got back from seeing that new French thriller, Cache,” said Olivia Black, a great grandmother from Portland, Oregon. “I was fine at the show, but on the way home in the car, I felt this burning pain in my chest. We wondered if I was having a heart attack, but then my daughter said it might be my reflux acting up.” The very well-preserved Black is slender, and she looks and acts a good 10 years younger than her 80 years. In addition to GERD she’d been having some problems with her arthritis and taking quite a bit of aspirin and ibuprofen.
“Sure enough,” Black said. “When we got everything sorted out, my doctor decided it was all the ibuprofen I was taking. Since I eased off on that, I haven’t had any acid symptoms that I can’t live with. That night, I thought I’d have to go to the hospital it was so bad. I was afraid it might really be my heart.”
GERD, or acid reflux as the medical condition is also called, occurs when the sphincter between the esophagus and the stomach relaxes too much to keep the contents of the stomach from escaping back into the esophagus. While the stomach lining is designed for an acid environment, the esophagus is not and so when stomach acids backwash into the delicate tube, irritation and inflammation like Black experienced can result.
Mayo Clinic Advice on GERD and Various Medications
According to Mayo Clinic literature, a range of medications can exacerbate acid reflux disease. These include “anticholinergics such as oxybutynin (Ditropan), hyoscyamine (Levsinex) and certain antidepressants.”
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Typical treatments for GERD include:
Lifestyle changes: Changing diet to include smaller portions, avoiding food that worsens acid reflux, eating at certain times in the day and elevating the head of the bed.
Medication options: Over the counter antacids are usually the first medication taken by GERD suffers. If over the counter drugs prove ineffective, doctors may prescribe proton pump inhibitors (PPI) such as esomeprazole, or H2 blockers such as Zantac and Pepcid.
Endoscopic options: These minimally invasive procedures alter the shape of the entry way between the esophagus and stomach in order to block the flow of acid coming into the esophagus. The Stretta procedure is an example of an endoscopic option.
Surgical options: Surgical procedures restructure the connection between the esophagus and the stomach in such a way to block acid flow coming up from the stomach. A common surgical option for GERD is called Nissen Fundoplication.
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Some sedatives and pain medications can also worsen GERD symptoms since they tend to relax the lower esophageal sphincter. Products like Valium, Restoril, codeine, and hydrocodone are in this category. Also, theophylline (Elixophyllin, Uniphyl), calcium channel blockers and nitrates, and progesterone can have similar effects. A raft of other medicines and even dietary supplements can also be contraindicated in patients trying to manage acid reflux, according to the Mayo Clinic.
“Especially when used on a regular basis... [these] can increase inflammation that GERD causes in the esophagus.”
The list is long and includes: potassium supplements, iron supplements, Vitamin C supplements, nonsteriodal anti-inflammatory drugs such as aspirin and ibuprofen (Advil, Motrin, others), antibiotics such as tetracycline, alendronate (Fosamax), and Quinidine.
Refresher Course on Gastroesophageal Reflux Disease
When the circular band of muscle around the lower end of the esophagus weakens to the extent that the contents of the stomach are allowed to back up, GERD symptoms can begin with a burning pain behind the breastbone.
Acid reflux is a common problem in the United States, affecting as many as 25 percent of the population. Additionally, 25 million Americans (out of a total of 296 million) will experience a mild form of reflux, often referred to as heartburn, on any given day.
The most classic form of GERD typically occurs after a big meal when a person experiences regurgitation of sour tasting food or liquid into the throat. Difficulty swallowing can also be present along with anxiety and shortness of breath. These worrisome symptoms can become more pronounced when lying down or bending over.
Foods that can sometimes aggravate acid reflux include fried items or other high-fat foods, peppermint, drinks that contain caffeine like coffee, tea and cola, and acidic foods like citrus fruits and tomatoes.
Food items that tend to lessen the severity of acid reflux and improve symptoms include fruits like bananas, apples and pears as well as foods that are low in acid, and low-fat, high-fiber foods from yogurt to polenta to whole grain cereals. In sum, the healthier a person eats, the better they will be able to manage their reflux.
Typical Management Approaches to GERD
Much relief is available by changing dietary and lifestyle habits. Eating smaller meals, raising the head of the bed, taking a walk after dinner to stimulate digestion, staying away from alcohol and tobacco, taking over-the-counter antacids like Tums, Maalox or Mylanta, and/or following your physician’s prescription medication suggestions can all help to lessen the discomfort of GERD. There also minimally-invasive endoscopic procedures as well as surgical procedures available for appropriate candidates. To learn more about possible treatments for GERD, click here .
