The link between GERD and GLP-1 medications

In this article:

1/ What is GERD?

2/ How to prevent GERD

3/ Medications for GERD

4/ GERD Complications

5/ The bottom line

In the cultural dialogue surrounding GLP-1 weight-loss medications, the only thing that gets brought up as often as their efficacy is their potential side effects. Gastrointestinal symptoms like nausea and diarrhea are the most common complications. The silver lining is that these symptoms are typically short-lived, resolving once the body adjusts to the medication. If you experience the side effect of GERD (gastroesophageal reflux disease), however, it may take a little more than patience to ameliorate your symptoms. Here’s what you should know.

What is GERD?

If you’ve ever eaten a meal, only to feel it burn back up through your chest shortly after, you’ve experienced acid reflux or, more colloquially, heartburn. Reflux can happen to anyone, occurring when the lid to the esophagus is left open. If this reflux happens frequently, however, it’s considered GERD — a more severe and long-lasting condition in which acid reflux causes repeated symptoms that are bothersome or lead to complications over time.

It’s estimated that 20% of American adults suffer from GERD, but it’s even more common among people taking GLP-1s. Since one of the main ways these medications work is by delaying gastric emptying, food sits in your stomach longer, increasing the risk of this recurrent reflux.

How to prevent GERD

If you’re taking a GLP-1, you can’t change the way they delay gastric emptying. You can, however, make adjustments to your diet and habits to prevent the reflux. Here are some strategies that may help:

• Identify which foods trigger GERD. Keep a food journal and try removing one food at a time to see how your body responds. If you aren’t seeing a difference after one to two weeks, that food may not be a trigger. Prioritize checking foods that are known potential triggers, including acidic foods like tomatoes or citrus, chocolate, caffeine, coffee, tea, carbonated beverages, fatty or fried foods, spicy foods, and alcohol.
• Eat an overall healthier dietary pattern. Aim for a diet comprised of lean proteins, healthy fats, and high-fiber foods like fruits, vegetables, beans, and lentils.
• Eat smaller meals. This can help with overstimulating your GI tract with large portions.
• Sleep with your head raised. Use a pillow or wedge to elevate your head while sleeping.
  

If you’re a member of WeightWatchers, these are modifications that you can make with the help of your WeightWatchers Registered Dietitian — they can even give you a personalized meal plan that takes your GERD into account.

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Medications for GERD

If the tips above don’t seem to help, you may benefit from medication. Your healthcare provider can make specific recommendations for over-the-counter or prescription treatments. Just keep in mind that there are two common types of GERD medications that have been associated with B-12 deficiency to varying degrees, and this risk increases significantly if taken for two or more years:

• H-2-receptor blockers: Examples include cimetidine, famotidine and ranitidine.
• Proton pump inhibitors: Examples include omeprazole, esomeprazole and lansoprazole.
  

‍If you are going to be on these medications long term, talk to your provider about whether you should take a vitamin B-12 supplement.

GERD complications

GERD is not something to just ignore, as it can lead to more serious complications over time, such as:

• Inflammation of the tissue in the esophagus (esophagitis)
• Narrowing of the esophagus (esophageal stricture)
• Precancerous changes to the esophagus (Barrett esophagus)
• Other complications like chronic cough, hoarseness and laryngitis, disrupted sleep, and the wearing away of tooth enamel
  
  

The bottom line

GERD (gastroesophageal reflux disease) is a recurrent condition wherein stomach acid flows back up through the esophagus, causing a burning sensation. It is a common symptom for people who take GLP-1s, since one of the major ways these medications work is by delaying gastric emptying. Certain nutrition and lifestyle tweaks, like avoiding high-fat or spicy foods and staying upright after eating, can help manage the condition. Medications including H-2 receptors and proton pump inhibitors can also help. If you experience GERD, make sure you talk with your healthcare provider — if left untreated, GERD can result in complications like narrowing of the esophagus and chronic cough.

This content is for informational purposes only and does not constitute medical advice, diagnosis or treatment. It should not be regarded as a substitute for guidance from your healthcare provider.