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The proton pump inhibitors have been used for over 30 years and have an excellent safety profile. Some people may experience problems with headaches, skin rash, diarrhea, and abnormal liver function studies but these side effects are extremely rare. Recently, there has been some suggestion that older individuals on long-term high dose, that is twice a day, proton pump inhibitors may have an increased bone fracture rate and, therefore, should be taking a calcium and vitamin D supplement. However this has not been substantiated. |
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Some people may experience problems from acid reflux in areas other than the esophagus. These are called extraesophageal symptoms. Sometimes the acid can spill over into the throat region and vocal cords and cause problems with a voice change, hoarseness, sore throat, and lump-like feeling in the throat region.
If the acid spills into the lungs, it can cause problems with cough, asthma, or infections. These symptoms can be the primary problem of reflux and the person may not even complain of associated burning in the chest or throat region. Some people develop a condition known as Barrett's esophagus, which is severe damage to the cells lining the bottom of the esophagus. Doctors believe Barrett's esophagus may increase the chance of developing esophageal cancer. |
Being overweight is a definite aggravating factor for reflux by increasing intrabdominal pressure.
Patients with long standing diabetes may develop decreased gastric emptying due to nerve injury to the stomach. This can also occur after certain stomach surgeries. Ulcers or cancers that block the stomach from emptying can cause reflux. Certain medications can contribute to reflux. Scleroderma is a rheumatological problem that can lead to reflux secondary to poor esophageal emptying and a decreased lower esophageal sphincter pressure. |
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It is very common during pregnancy for reflux to be a problem. The fetus increases the abdominal pressure and the hormones of pregnancy may decrease the lower esophageal sphincter pressure. Also If the stomach doesn’t empty because of a motility problem or a blockage then there is a greater risk for acid to reflux into the esophagus. |
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Normally the esophagus is located above the diaphragm and the stomach is below the diaphragm. The lower esophageal sphincter lies at the level of the diaphragm in between the esophagus and stomach. The diaphragm is a muscle that separates the chest from the abdomen. A hiatus hernia occurs when a portion of the stomach adjacent to the esophagus pushes up thru the diaphragm and rests above the diaphragm in the chest region. A hiatus hernia is a common occurrence and often causes no problems. Many individuals have reflux and do not have a hiatus hernia. In some individuals it may contribute to reflux. The diaphragm squeezes on the sphincter when it is normally located at the level of the diaphragm and helps to increase the pressure in this region. When the sphincter is situated above the diaphragm in the setting of a hiatus hernia the diaphragm can no longer assist the effect of the lower esophageal sphincter pressure. Also sometimes acid can be trapped in the hiatus hernia and be a reservoir for acid to more readily reflux into the esophagus. |
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Important: This information should not be used as a substitute for the medical care and advice of your physician. 
