Reflux Treatment with Long Term Medication

Reflux Treatment and Medicine

When the most basic measures, such as the use of antacids or alginate containing compounds or dietary mechanical measures do not work, many will often turn to medication.  I think it’s very important to understand that the use of medication for the control of reflux is nothing more than a bandaid approach to the disease, the medications that we currently use are designed to do one thing.  Whether it be the class known as H2 inhibitors, which you may know as Zantac or Tagamet or Pepcid, or whether you’re talking about the class known as Proton Pump inhibitors, such as Nexium, Omeprazole, Pantoprazole, Aciphex or Dexilant, all of these medications are designed to do one thing and one thing only.  That is to decrease the amount of acid that your stomach produces.

However, this has no impact whatsoever on the progression of your disease, or the risk of developing more serious types of disease from reflux, such as Barrett’s esophagus or even cancer of the esophagus. Why is that?  They do not eliminate all of the acid produced by your stomach.  Again, the sphincter is the weak link in the chain here.  Because the sphincter is weak you’re still refluxing, but you’re just not refluxing as much acid.  Make no mistake, the small amount of acid as well as the bile and the pepsin that comes from the stomach can cause as much damage in the esophagus as well as in the larynx and still create significant symptoms.

It is important to remember that these medications are temporary bridges to more definitive therapy. What we like to encourage people to try is to take medication for a day or two, or a week or two, or maybe from time to time.  However, once you are chronically dependent on the need to take a medication to control your symptoms, at that point there has been sufficient degeneration of the lower esophageal sphincter that your reflux disease is not going to get any better, increasing your risk from more serious symptoms. 

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