Question: What are some of the prescription medications that are used to treat GERD (gastroesophageal reflux disease), how do they work and what are the risks/side effects?
Answer: The main class of prescription medications used to treat GERD are the proton pump inhibitors of which Aciphex and Nexium are two examples. These medications are the most potent suppressors of acid production in the stomach. Because most symptoms of GERD are due to acid, escaping from the stomach and entering the lower esophagus, these medications have been shown to be effective in well over 95 percent of patients with gastroesophageal reflux disease.
Their widespread use has also been because of their safety profile. For the most part these medications are safe, especially when used for short periods of time and even patients requiring long term therapy with proton pump inhibitors have very minimal side effects.
There are two particular groups of patients that need to be aware of side effects however. One are young women who are on proton pump inhibitors for extended periods of time. There's studies have shown that higher incidence of osteopenia or osteoporosis, which is a weakening of the bones, in these patients. The second group of patients that should be aware of long term side effects are elderly patients who are hospitalized. These patients have been found to have increased incidences or increased rates of particular types of infection, particularly pneumonias and particularly devastating type of intestinal infection called C. difficile. This is a type of colitis or infection in the large intestine that can result in diarrhea and considerable sickness.
Patients on long term proton pump inhibitors should be aware of these complications but for the most part, in young and middle aged patients, long term use is safe.