Gastroesophageal Reflux Disease (GERD): Overview for Clinicians

An integrative approach to GERD includes a variety of evidence-based options including:

  • Lifestyle changes
  • Nutrition and exercise
  • Botanical (herbal) medicine
  • Pharmaceuticals
  • Mind-body therapy
  • Traditional Chinese medicine
  • Surgery

Risks of prolonged acid suppression therapy:

  • Increased risk of community-acquired pneumonia
  • Increased risk of community-acquired Clostridium difficile infection
  • Increased risk of bone fracture
  • Decreased absorption of iron, specifically non-heme iron
  • Decreased absorption of vitamin B12
  • Decreased absorption of calcium
  • Gastric hyperplasia (due to gastrin stimulation)

Be cautious using acid suppression in:

  • Patients with iron deficiency anemia (unless due to bleeding ulcers)
  • Elderly individuals at risk of community-acquired pneumonia
  • Children for long periods of time due to risk of gastric hyperplasia
  • Post-menopausal women, or other individuals at risk for fractures

Rebound hyperacidity can occur when discontinuing a PPI and last for 10-14 days even if GERD has resolved. A suggested plan to help patients taper off PPIs is included in the downloads section on the right.

Please see the downloads section at the right for more detailed clinician and patient information.

Disclaimer: This information is for general education. Please work with your health care practitioner to use it in the best way possible to promote your health.