Managing GERD: Lifestyle Changes vs. OTC Medications

Patient Expert
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Many people reach for over-the-counter antacids and medications to ease physical discomfort after eating a big platter of, say, fried and greasy food. But what if long-term use of some of these common medications can lead to serious health problems?

An eye-opening study from Houston Methodist asked that very question, and found that chronic use of the commonly used heartburn and gastroesophageal reflux (GERD) drugs known as proton pump inhibitors (PPIs) may increase the speed at which cells lining the inside of blood vessels age. In turn, this change in the cells’ aging process may lead to a heightened risk of cardiovascular disease, vascular dementia, and renal failure.

From Teflon to Velcro

The study found that certain drugs — sold under names like Nexium, Prevacid, and Prilosec —alter the cells lining the inside of blood vessels. These cells naturally have a Teflon-like coating that prevents blood from sticking to the vessel’s lining. However, PPIs are believed to cause these cells to become more like Velcro, thus allowing blood elements to stick and form blockages that can lead to strokes and heart attacks.

While proton pump inhibitors don’t require a doctor’s supervision and are effective when taken as directed, researchers believe many people overmedicate themselves with these drugs. In fact, the study’s analysis suggests that up to 70 percent of the use of these medications may be inappropriate. ("In 2009, PPIs were the third-most taken type of drug in the U.S., and are believed to account for $13 billion in annual global sales," according to a Houston Methodist press release.)

Lifestyle choices matter

This research underscores the need to make healthy lifestyle choices and use these decisions as the first line of defense against GERD and heartburn. Lifestyle changes that could help include:

  • Change your eating patterns. Eating smaller meals throughout the day puts less stress on the digestive tract and keeps acid from backing up into the esophagus. In addition, avoid foods that may trigger GERD and acid reflux; these foods include fried foods, fatty foods, alcohol, garlic, mint, onion and caffeine.  Commit instead to eating a heart-healthy diet that includes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts, legumes and non-tropical vegetable oils.
  • Lose weight. A healthy weight helps prevent acid reflux because extra pounds put pressure on the abdomen, thus causing acid to back up from the stomach to the esophagus.
  • Wear looser clothing. Tight-fitting clothes can also put pressure on the intestinal tract, thus leading to heartburn.
  • Avoid smoking. Smoking actually hampers the lower esophageal sphincter’s ability to function.
  • Avoid lying down immediately after eating. Try to stay in an upright positon for at least three hours after a meal to allow food to digest and move through the digestive tract. If you experience GERD or heartburn during the night, try elevating your torso while you sleep by, if possible, raising the head of your bed.

See More Helpful Articles:

The 411 on GERD

Treatment Options for GERD

Sources:

American Heart Association. (2015). The American Heart Association’s Diet and Lifestyle Recommendations

Cooke, J. (2016). Proton pump inhibitors accelerate endothelial senescence. Circulation Research

Houston Methodist. (2016). Common Antacid Linked to Accelerated Vascular Aging

Mayo Clinic. (2014). GERD