Proton pump inhibitors (PPI) which decrease acid production in the stomach are the main type of medications prescribed for treatment of GERD. Research suggests that use of this type of medicine may reduce the absorption of certain minerals and vitamins. In a study conducted in the United Kingdom, 44% of patients using PPIs had an increased risk of hip fractures because of calcium malabsorption. Calcium is inadequately absorbed in the body due to decreased acid in the stomach, which is termed achlorhydria. There is a strong correlation with the incidence of hip fractures related to the amount of dosage and strength of the dosage of the PPI. The longer and higher the dose of PPI taken by the patient with GERD, the more their risk for hip fractures increases. Vitamin B12 is also affected by taking PPI medication. It may also not be absorbed properly when under the care of acid suppressing medicine. Long-term use of PPI medication decreases the levels of Vitamin B12, a protein bound vitamin, absorbed by the body. Gastric Acid is needed for the intrinsic factor to be present and absorb the extrinsic factor (Vitamin B12); therefore, low levels of gastric acid greatly impair the absorption of Vitamin B12.
GERD is a condition that may have more serious complications if left untreated. It can increases the risk of Barrett’s esophagus and esophageal or stomach cancers in patients, particularly when it is left uncared for. The esophageal lining is damaged by the repetitive contact of acid that escapes from the stomach which can cause ulcers and bleeding. Narrowing also occurs due to scar tissue build up. Irregular restoration of the esophagus from damages made by acid leads to a condition termed as Barrett’s esophagus. The condition is characterized by an abnormal shape and color from new adaptive cells that could lead to cancer. Research indicates adenocarcinoma of the esophagus and gastric cardia are the fastest rising cancers within the US. GERD can also lead to the decay of teeth through the regurgitation of acid into the throat and mouth. Asthma can develop due to lung damage caused by breathing in acid into the lungs.
Some research suggests that the reason for increased gastric acid secretion back into the esophagus is because of low stomach acid instead of high stomach acid along with a weak esophageal sphincter (muscle that opens with swallowing to allow food to pass to the stomach). Digestion cannot take place properly without enough acid; therefore, food and acid regurgitate into the esophagus. The research is still underway but is showing increasing evidence because of the fact that stomach acid decreases with age. If the research is found to be true then acid reducing medications may be making symptoms worse.
With seeing the risks of taking and not taking the medications prescribed for GERD, patients are left in quite a predicament. Should they not take a medicine that blocks their absorption of certain nutrients and may worsen their condition or should they take it to ward off the incidence of cancer? With research the hope is that answers will soon be available. For now tips are available to help fight GERD with or without medication:
- Eat smaller meals and snacks instead of 2 or 3 large meals to alleviate pressure
- Chew gum after meals
- Avoid refined flours, sugar, and trans fats
- Avoid overly spiced foods
- Keep a food journal to track symptoms
- Do not lie down for 2 to 3 hours after a meal
- Elevate the head of the bed with blocks about 2 or 3 inches
- Do not use extra pillows as this bends the esophagus creating more pressure
- Quit Smoking if you smoke
- Avoid tight fitting clothing
- Lose weight if overweight
- Remove stress from your
- An alternative medicine approach is to drink 2 tsp of apple cider vinegar to aid in digestion
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