GERD or Gastroesophageal Reflux Disease is commonly called acid reflux. In the US it is a very common condition affecting 10-20% of the population. Obesity, smoking, and certain medications are all risk factors.
It is common in pregnant women due to the increased intra-abdominal pressure caused by the fetus during pregnancy. GERD is due to failure of the lower esophageal sphincter, which is between the stomach and the esophagus to properly close. It is generally a chronic condition in which stomach contents rise up or “reflux” into the esophagus, leading to symptoms that include: an acidic taste in the mouth, regurgitation, and heartburn; a pain in the chest that can mimic heart attack.
Other symptoms can include: pain with swallowing, hoarseness of voice and coughing. Ongoing acid reflux can lead to more severe conditions such as damage to teeth enamel, esophagitis, esophageal ulcers and Barrett’s esophagus. Barrett’s esophagus is associated with an increased risk for esophageal cancer and stricture of the esophagus.
Proton Pump Inhibitors (PPI’s) are among the most commonly prescribed drugs and over the counter medications. Doctors prescribe them like candy, apparently under the (incorrect) assumption that they are as safe as candy. Such is not the case. Prilosec (omeprazole) is the most commonly prescribed PPI with over 50 million prescriptions last year. It and other PPI drugs, acid reducers, and acid blockers (Axid, Nexium, Pepcid, Pepto-Bismol, Prevacid, Protonix, Tagamet, Tums, Zantac) are used to treat acid reflux or GERD, dyspepsia, stomach and duodenal ulcer, as part of a program to eradicate H. pylori, Barrett’s esophagitis, gastritis and gastrinomas.
Unfortunately, these drugs fail to address the underlying causes of heartburn and GERD. In fact, they make it worse, often creating a vicious cycle so that people who start taking PPI’s end up taking them for the rest of their lives.
Antacids, acid blockers and PPI’s are cash cows for Big Pharma. Over 60 million prescriptions for GERD were filled in 2004. Americans spent $13 billion on acid stopping medications in 2006. Nexium brings in $5.1 billion; right behind Lipitor, the biggest money-making drug on the market. This is likely an underestimate due to the availability of many of these drugs over the counter. These people never see a doctor, so their GERD is not reported.