Reflux

Causes and risk factors for GERD include:

• Weakened lower esophageal sphincter
• Obesity
• Hiatal hernia
• Pregnancy
• Smoking
• Certain foods and beverages (e.g., fatty or fried foods, alcohol, coffee)
• Delayed stomach emptying

Symptoms of GERD include:

• Heartburn (burning sensation in the chest)
• Acid regurgitation
• Difficulty swallowing
• Chronic cough or sore throat
• Sensation of a lump in the throat
• Dental erosion

In Australia and around the world:

• Proton Pump Inhibitors (PPIs): Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid)
• Histamine-2 Receptor Antagonists (H2RAs): Ranitidine (Zantac), Famotidine (Pepcid)
• Antacids: Aluminum hydroxide/magnesium hydroxide (Mylanta)

• PPIs: Osteoporosis, kidney issues, vitamin B12 deficiency, infections
• H2RAs: Headaches, diarrhea, fatigue
• Antacids: Constipation, diarrhea, magnesium or calcium imbalances

GERD affects about 20% of the adult population globally. 

In Australia, it's estimated that around 11.6% of adults suffer from GERD.

• Dietary Changes: Avoiding trigger foods like fatty foods, chocolate, caffeine
  • Reference: Kaltenbach T, et al. Dietary trigger foods in GERD. Digestive Diseases and Sciences. 2006.
• Weight Management: Weight loss in those who are overweight or obese
  • Reference: Singh M, et al. Weight loss can lead to resolution of GERD symptoms: A prospective intervention trial. Obesity. 2013.
• Herbal Remedies: Slippery elm, licorice, chamomile
  • Reference: Khayyal MT, et al. Mechanisms involved in the gastro-protective effect of STW 5 (Iberogast) and its components against ulcers and rebound acidity. Phytomedicine. 2006.
• Acupuncture: Some studies suggest acupuncture can be effective in treating GERD symptoms.
  • Reference: Dickman R, et al. Clinical trial: acupuncture vs. doubling the proton pump inhibitor dose in refractory heartburn. Alimentary Pharmacology & Therapeutics. 2007.

De-prescribing in GERD often involves reducing or stopping medications while emphasizing lifestyle and dietary changes.

• Lifestyle Interventions for GERD: A study on the effect of a plant-based, Mediterranean-style diet along with alkaline water showed significant symptom reduction.
  • Reference: Zalvan CH, et al. A comparison of alkaline water and Mediterranean diet vs proton pump inhibitor for laryngopharyngeal reflux. JAMA Otolaryngology–Head & Neck Surgery. 2017. Link
• Tapering Off PPIs: Studies support gradual reduction with the inclusion of alternative therapies and lifestyle changes.
  • Reference: Reimer C, et al. Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. Gastroenterology. 2009. Link

GERD is a manageable condition with both pharmaceutical and non-pharmaceutical approaches. De-prescribing programs for GERD can be successful with careful planning, lifestyle modifications, and ongoing medical oversight.