Medications for Gastro-oesophageal Reflux Disease

Gastro-oesophageal Reflux Disease (GORD) is a common condition affecting up to 20% of Australians adults weekly. Proton pump inhibitors (PPIs) are common and highly effective medications used to treat reflux. PPIs are some of the most commonly prescribed medications in Australia.  The government has recently implemented changes to the PBS to restrict the prescription of high dose PPI to situations where other treatment measures have failed or patients have specific conditions.

Things have become more complicated recently due to alternatives like H2 blockers (histamine 2 receptor antagonists) being unavailable.

Proton pump inhibitors are generally very safe and  are available over the counter in many countries. Most people can take PPIs for long periods of time without affecting their health, although there is some disputed evidence there may be adverse effects associated with long term use. These include:

·   Reduced bone density and increased risk of osteoporosis

·   Increased risk of pneumonia   or diarrhoea

·   Possible nutritional deficiencies such as vitamins and minerals.

·   A small risk of kidney damage 

It is good practice to use medications where there is a clinical need, and to use them in the lowest dose and for the shortest timescale required. In line with this the Royal Australia College of General Practitioners recommends ‘regular attempts at reducing dose or ceasing’ PPIs. There are situations  were some patients will require long term treatment , and this may include those with Barrett’s oesophagus, gastrointestinal bleeding or severe oesophagitis.

This is not intended to  provide medical advice to individual  patients. You should consult your regular doctor before changing  any  prescribed medications.

The Doctors at  Reydon Street Medical Centre would be happy  to discuss your PPI use and review the need for ongoing treatment.

For more information:

<https://www.nps.org.au/professionals/managing-gord-with-ppis-in-primary-care>

<https://www.nhsaaa.net/media/1858/20170223ppis.pdf>

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