When Meds Make A Meal: RA & GERD
There are so many bottles of medication sitting on my kitchen side counter that I have no doubt my poor stomach feels as if it is under assault. Many people taking NSAIDs and medications like Methotrexate end up with GERD, Gastroesophageal reflux disease, and/or Gastritis, which is an inflammation of the stomach lining.
Those of us with RA generally take NSAIDs on a regular basis, and Prednisone during flares. These two medications are especially harsh on our stomachs and can lead to the damage of stomach mucosa.
I had the misfortune some years ago to see a rheumatologist who prescribed 2400 mg of Ibuprofen for a year. I didn’t know any better, so I did as he said. Consequently, I have chronic gastritis. I take 150 mg of Zantac every morning and watch my diet closely to deal with this issue.
A lot of doctors prescribe OTC or prescription Proton Pump Inhibitors, such as Priolsec or Prevacid. These medications have helped many people control their GERD and chronic gastritis, and enabled them to continue taking oral medications they otherwise would have to discontinue.
Symptoms of GERD include heartburn, trouble swallowing, and regurgitation. Less common symptoms include chest pain, nausea, and increased salivation.
People with Gastritis may not experience any symptoms, but the most common symptom is pain in the upper central abdomen. The pain I have, if I am not careful with my medications and diet, is a burning, gnawing pain.
The thing that irritates my GERD and Gastritis the most is caffeine. I must confess that I like to have a Coke Zero in the afternoon. The caffeine gives me a boost, and I just happen to like Coke. The only way I am able to have my Coke Zero is to take my Zantac every morning, and to avoid foods that aggravate my condition the rest of the day. I also never have a Coke Zero on an empty stomach. Those days are long gone. Admittedly, drinking caffeine does irritate the stomach mucosa. Best to stay away from caffeine if you are experiencing symptoms of GERD or Chronic Gastritis.
Some other tips for avoiding the pain and discomfort of GERD and Gastritis are:
A. Raise your upper body when you sleep, or sleep sitting up, and sleep on your left side to keep gravity working for you.
B. Eat smaller meals during the day, and avoid eating right before bedtime.
C. Lose a few pounds. The connection between excess weight and GERD & Gastritis is not clear, but losing weight does seem to help, perhaps by decreasing pressure on the stomach.
D. Avoid foods that cause symptoms. Most often people have trouble with highly acidic foods and foods which have a high fat content.
Many of the people I know who take NSAIDs on a regular basis also take Zantac or a prescription Proton Pump Inhibitor. We all need to take our medications. They help us, but they also have the potential to do damage, especially to our digestive systems. If you are having symptoms of GERD or gastritis, please make an appointment with your doctor. He or she will likely prescribe medication to help your stomach handle your other prescriptions. Keeping our stomachs healthy is important, especially when we take enough meds to make a meal!
Vanessa wrote for HealthCentral as a patient expert for Rheumatoid Arthritis (RA).