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 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.