GERD Drugs May Cause Unexpected Side Effects

Nov 1 2009 - 7:47pm
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People who are taking drugs called proton pump inhibitors to treat GERD (gastroesophageal reflux) and laryngopharyngeal reflux (LPR) should be aware of possible unexpected side effects and complications, according to a new report published in Otolaryngology—Head and Neck Surgery. These additional adverse effects are in addition to the ones normally associated with use of proton pump inhibitors, which include headache, diarrhea, abdominal pain, dry mouth, constipation, nausea, rash, and flatulence.

Experts do not know exactly how many people have GERD or LPR, as some people do not seek treatment from a physician for their symptoms. It is estimated that 20 percent of people experience heartburn or acid regurgitation on a weekly basis and that 40 percent of people experience these symptoms at least once a month. The American Gastroenterological Association suggests that one-third of the US population has GERD.

Proton pump inhibitors, which work by preventing the release of stomach acid, are a popular treatment for GERD and LPR, and they are generally regarded to be safe. Recent research has indicated that stomach acid is not the only factor that causes tissue damage in reflux disease, however, and this fact, along with indications that proton pump inhibitors are associated with unexpected complications, prompted the authors of the new research to raise a red flag about use of these medications.

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Some of the unexpected side effects and complications the authors noted related to the use of proton pump inhibitors for GERD include an increased rate of hip fractures (which may be related to problems with calcium absorption), the possibility of altered absorption of iron and vitamin B12 (related to changes in gastric pH levels), an increased risk of developing diarrhea caused by clostridium difficile related to medical treatment, and an increased risk of contracting community-acquired pneumonia. In an unrelated recent study, use of proton pump inhibitors was found to cause weight gain.

Given their findings, the authors of the study suggest that physicians reevaluate their patients who are taking proton pump inhibitors for GERD or LPR to determine whether they need to continue taking these drugs and to weigh the risks of treatment versus not treating the disease. Current proton pump inhibitors on the market include dexlansoprazole (Kapidex), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex).

Physicians are also encouraged to consider alternative treatment approaches for GERD, including changes in diet and lifestyle. Some modifications that can be helpful include avoiding certain foods (e.g., fatty and/or fried foods, spicy foods, soft drinks, tomatoes, chewing gum, coffee, alcohol), stopping smoking, eating smaller meals, and practicing relaxation techniques.

SOURCES:
Altman KW, Radosevich JA. Otololaryngology—Head and Neck Surgery 2009 Nov; 141(5): 564-66
American Gastroenterological Association

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