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Medication and Heartburn

Certain medications taken for health conditions may trigger heartburn or make your acid reflux pain worse. Take a look at this list to see if any of your medications may be contributing to your acid reflux.

  • Aspirin – The aspirin you take for headache pain or for heart attack prevention may cause your stomach to produce more acid, which could lead to increased heartburn.
  • Ibuprofen – Common over-the-counter medicines, such as Advil and Motrin contain ibuprofen, which can increase the production of acid within your stomach.
  • Antibiotics – Certain antibiotics, such as those used to treat bacterial infections, can cause symptoms of acid reflux. Check with your Arlington physician to see if an enteric-coated antibiotic, which is gentler on the stomach and esophagus, can be taken for your medical condition.
  • Blood Pressure Medications – Beta blockers and calcium channel blockers can relax the lower esophageal sphincter muscle, allowing stomach acid to creep up into the esophagus more easily.
  • Osteoporosis Medications – Bone-strengthening drugs such as Boniva (ibandronate), Actonel (risedronate) and Fosamax (alendronate) are common heartburn triggers. Taking these medications before eating or drinking may help minimize your acid reflux symptoms. In addition, newer osteoporosis medications are now available that are more gentle on the stomach and can be taken less often.
  • Antidepressants – Some of the older types of tricyclic antidepressants tend to slow the rate of speed at which the stomach empties itself. When food and acid sits in the stomach longer, it increases the likelihood of acid reflux.
  • Iron Supplements – Iron supplements help the body produce red blood cells, but they can also provoke acid reflux. If your iron supplement is a heartburn trigger, ask your Arlington doctor if there is an alternative you can substitute.
  • Sedatives – Medications taken to help you to relax or sleep, may also relax your esophageal sphincter muscle, leading to heartburn.
  • Potassium – Potassium supplements, often recommended for people with high blood pressure, can irritate the esophageal lining. To minimize your chance of having acid reflux when taking potassium supplements, wash down the pill with plenty of water or take an enteric-coated slow release form of potassium.

 

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Zinc Supplements Could Help GERD

Ft. Worth residents that suffer from frequent heartburn and acid reflux may be suffering from GERD. What is GERD exactly? GERD is an acronym for Gastroesophageal Reflux Disease, and it is a condition whereby stomach contents (food, liquid, or acid) run backwards out of the stomach into the esophagus. This backward flow irritates the esophagus lining, leading to heartburn, coughing, burning, hoarseness, chest pain, difficulty swallowing, or the feeling of a lump in the throat.

Traditional medications to treat GERD include antacids taken to neutralize acids, medications taken to reduce acid production, and medications to block acid production. Now, according to a recent study out of Yale University, zinc salts may help to relieve the uncomfortable and often painful symptoms of GERD, without any of the side effects, such as headache, dizziness, or diarrhea that are occasionally experienced as a result of traditional GERD medications.

The study participants included 12 people who took zinc salts to treat their gastroesophageal reflux disease symptoms. The participants reported quick relief — sometimes in a matter of minutes — without experiencing any side effects.

Experts in the field are cautionary, stating that too much zinc may lead to an upset stomach. People who suffer from GERD should make dietary and lifestyle modifications (losing weight, eating smaller meals, avoiding food triggers) first to see if symptoms are relieved. Persistent heartburn should never be ignored because it can lead to precancerous or cancerous changes in the lining of the esophagus, and so if you are experiencing the symptoms of GERD it is important that you speak with your physician before starting any home-remedy program.

While the study was quite small, it opens the promise of new, effective treatment methods for patients suffering from Gastroesophageal Reflux Disease who experience side effects from traditional medications or where traditional medications fail to help relieve their symptoms.

 

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Prilosec

Prilosec (Brand name: omeprazole, sodium bicarbonate) is in the proton pump inhibitors (PPI) class of drugs. This medication works by impeding the production of stomach acid. FDA approved in 1989, Prilosec reduces the production of stomach acid by preventing the enzyme in the stomach wall from producing acid, which, in turn, allows the esophagus and stomach to heal.

Prilosec is used to treat Gastroesophageal Reflux Disease (GERD), ulcers and Zollinger-Ellison syndrome — all of which are caused by excess stomach acid. This medication is also used in critically ill patients for the prevention of upper GI bleeding. Prilosec is also prescribed to treat erosive esophagitis and heartburn. In combination with antibiotics, Prilosec is used to treat H. pylori infections.

Prilosec should be taken whole and before meals. The recommended dose of Prilosec for Gastroesophageal Reflux Disease, ulcers, H. pylori and erosive esophagitis is 20 to 40 mg on a daily basis. H. pylori infections are typically treated for 10 to 28 days, while ulcers take four to eight weeks of healing time. For heartburn, physicians generally prescribe 20 mg daily for a period of up to two weeks. The beginning dose for treating Zollinger-Ellison Syndrome is 60 mg daily; your Dallas physician will adjust your dose accordingly depending on your response.

Prilosec and other PPIs are well-tolerated. Nausea, vomiting, diarrhea, rash, headaches, and dizziness are the most common side effects. Water retention, abnormal heartbeat, nervousness, leg cramps, weakness, and muscle pain occur infrequently.

Because extended use (one year or longer) and high doses may increase the risk of wrist, hip and spine osteoporosis-related fractures, your Fort Worth doctor will prescribe the shortest duration and lowest dose needed to treat your condition.

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Do Acid Reflux Drugs Carry Fracture Risk?

You may want to explore options other than medication to relieve your heartburn. While a certain class of drugs aimed at relieving gastroesophageal reflux disease may go a long way in reducing the acid produced in your stomach, they may also be harming your body’s ability to absorb bone supporting minerals.

PPI’s or proton pump inhibitors such a Nexium, Prevacid and Prilosec have been used for years to counter the effects of heartburn, but studies show that these drugs inhibit the absorption of calcium especially in those who have taken the prescription medications for a year or more. The FDA has confirmed these findings and adds that people taking a high dose of PPI’s are also at increased risk for fracture in the wrist, hips, and spine.

The general public has not been aware of these findings and the proliferation of these types of drugs on the market puts many at risk. For this reason the FDA is instructing PPI manufacturers to include fracture risk information on the labels of both prescription and over-the-counter versions of these drugs.

Heartburn occurs when the lower esophageal sphincter, a small flap located at the top of the stomach weakens and allows food and stomach acid to reflux into the esophagus.

Researchers suggest that some alternatives to PPI drugs may be altering your diet to include probiotics and vitamin D. Reduce foods that trigger heartburn such as sugars, processed foods and alcohol, and implementing an exercise regimen to improve your body’s immune system.

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Are There Long-Term Side Effects of PPIs?

Proton pump inhibitors, or PPIs, are a class of drugs used for persistent reduction of gastric acid. PPI’s are used to treat a variety of stomach conditions, such as gastroesophageal reflux disease (GERD), ulcers, indigestion, acid reflux and heartburn. Some 100 million prescriptions of PPIs are filled in the United States each year. Examples of PPI’s include Prilosec, Aciphex, Nexium, Protonix and Prevacid. People are now able to treat themselves, with similar medications available over-the-counter. However, recent studies suggest concerns over long-term side effects of PPIs.

Increased Risk of Pneumonia

According to a 2007 article in the Archives of Internal Medicine, an increased risk of pneumonia was linked to proton pump inhibitors. Although the exact causal relationship is not known, researchers believe that the decrease in stomach acid allows bacteria that cause pneumonia to grow and spread.

Fracture

Increased risk of fractures is another concern with the use of PPIs. In fact, the FDA is now requiring all package inserts for PPI to disclose this risk. More than a handful of studies reported that wrist, hip and spine fractures were more prevalent in people taking PPIs for gastroesophageal reflux disease or other stomach condition, than those not taking these medications. By reducing stomach acid levels, proton pump inhibitors may have an impact on your body’s absorption of calcium. A decrease in calcium level may lead to increased fractures or osteoporosis.

C. difficile Infection

The risk of C. difficile infection in hospitalized patients taking PPIs was increased, according to a 2010 study. C. difficile infection can lead to severe dysentery, long standing colon problems and possibly death.

Vitamin B12 Levels

Similar to the body’s reduced ability to absorb calcium with reduced stomach acid, PPIs may also impact the body’s ability to absorb vitamin B12s. A deficiency of B12 may lead to anemia, gastrointestinal issues or neurological symptoms. For this reason, doctors routinely measure vitamin B12 levels while a patient is taking proton pump inhibitors for gastroesophageal reflux disease or other conditions.

What You Can Do

While the studies are just beginning to suggest some long-term side effects of PPI use, more studies will need to be conducted. If you only have occasional acid-reflux issues, it may be time to learn about your triggers. If chocolate, coffee or onions cause you to have heartburn, you may want to limit your consumption of them instead of popping PPIs. If nighttime heartburn is your only problem, consider raising the head of your bed. Sometimes the saliva produced from chewing gum, may be enough to wash the stomach acid back down into the stomach where it belongs. Of course, people with severe gastroesophageal reflux disease, may still need to take PPIs. It’s best to speak with your physician before starting or stopping a PPI therapy.

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Zegrid Oral

Indication:
Zegrid Oral is prescribed to treat ulcers, gastroesophageal reflux disease (GERD), and other conditions involving excessive stomach acid production, such as heartburn. Zegrid Oral is a combination of omeprazole and sodium bicarbonate. The medication works by decreasing the amount of acid your stomach produces and raising the pH in your stomach. Zegrid Oral may also be prescribed to lower the risk of stomach bleeding in some patients.

Side Effects:
Common side effects for Zegrid Oral include headache, nausea, stomach pain, diarrhea, constipation, white patches or sores inside your mouth or lips, and mild fever. Some Zegrid Oral side effects are serious, including allergic reaction. Seek help immediately if you experience any of the following: wheezing or difficulty breathing; irregular, pounding, or racing heartbeat; itching, swelling, or hives; and hoarseness or difficulty swallowing. You should also talk to your doctor if you experience a serious side effect such as easy bruising or bleeding, unusual weakness, or a fast, slow or uneven heartbeat. These may be symptoms of a more serious condition. Zegrid Oral may cause unexpected side effects that are not described above. If you experience an unanticipated reaction while on Zegrid Oral, talk to your doctor immediately.

Precautions:
Like any medication, there are some risks associated with taking Zegrid Oral. Zegrid Oral contains high levels of sodium. If you are on a low-sodium diet, Zegrid Oral may not be right for you, and you should tell your doctor about any dietary restrictions you have. Zegrid Oral contains omeprazole, a proton pump inhibitor, which taken in high doses or with prolonged use, may increase your risk for bone fractures. Other medications may interact with Zegrid Oral. These include medications and supplements that need stomach acid in order to be properly absorbed, such as ampicillin, iron supplements, dasatinib, and azole antifungals. It is not known whether Zegrid Oral can harm an unborn child, although the medication can pass into breast milk and may harm a nursing baby. If you are pregnant or breast feeding, talk to your doctor about the benefits and risks associated with using Zegrid Oral.

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