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Does GERD usually worsen over time??

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Posted 11/11/2011 12:43 AM (GMT 0)
Hi everyone,

I've been wondering if GERD is progressive or worsening over time? I am only 30 now so I'm just wondering how best to manage this beast. I am wondering how long PPI's usually work. I'm also concerned about taking them for 20 + years with the whole risk of fracture thing.

In addition, if you have a Nissen, and it lasts about ten years ...that means I could end up having 4 or 5 of them before I die and I question if my digestive system will even be able to process solid food! I know I'm getting a little ahead of myself but this whole thing has kind of got me down / worried.

Thoughts appreciated.

Thanks,
Liz
Posted 11/11/2011 9:46 AM (GMT 0)
Hi Liz, I understand your concern - I'm only in my 40s so I agree it's a long stretch ahead, especially if it did get worse. My GERD is poorly controlled in that the drugs don't help much, but there's not that much to see on the scope, so the doctors class me as mild and not worthy of further intervention. My symptoms seem to far outweigh my actual pathology. So, I guess it depends - your symptoms may get worse without your pathology getting worse, and vice versa.

Whether we get worse or not must depend on the cause. In my case no one is sure about the cause. If yours is purely structural then surgery may be the only way to manage it. If you can find stress or lifestyle triggers, then maybe you can slow things down.

It's a crystal ball question really!

MMM
Posted 11/11/2011 3:00 PM (GMT 0)
Hey Liz,

I must say that yes it does sometimes get worse with time. I'm still getting new symptoms (lump in throat, nausea) after all of my weight loss and lifestyle changes. I'm sorry hun :(

Ash
Posted 11/12/2011 12:28 AM (GMT 0)
I have been dealing with this for less than a year, so I don't know from personal experience. Hanging out here, I have seen several posts from people who have been taking a PPI with great success, and now it doesn't work any more. It does seem like people develop more symptoms over time. Even after surgery, my impression is that people often do great for awhile, then sometimes they develop problems again. I know very little about lifestyle changes for all of these scenarios. If you are feeling well, it is easy, maybe inevitable for most, that you start eating foods again that may lead to problems in the long run. The same might be said for all of the lifestyle changes recommended for GERD. So maybe your best chance to avoid getting worse is to adhere to lifestyle changes. On a positive note, I have read that the lifespan of surgical correction procedures for GERD keeps getting longer.
Posted 11/12/2011 1:46 AM (GMT 0)
I've been trying to find an answer to this as well and haven't found a clear answer yet. Statistics indicate that if not managed, it can continue to get worse .. but they also say that one can manage it and can keep the symptoms away ...

I am not considernig the cases here when the etilogy of GERD is due to structural problems (hernia etc.).. since in those cases, PPIs or surgery are the only real options ..


- My first GI told me - "he has seen some of his patients get better even without medication".
- My second (current) GI told me - "it usually waxes and wanes - but it is highly unlikely it will ever completely go away"
- My second ENT told me - "some of his patients did get better over a period of 6-12 months or so with / without medication"
- Another ENT told me - "you can manage it without medication - with diet and lifestyle modifications and keep the symptoms at bay"

4 of my friends/acquaintances have had differing experiences:
- One got a bout in 2005 or so - that lasted for 9 months and he got better with lifestyle modifications - and hasn't had it since
- Another one has to be in on 2 PPIs/day to control it since 2004 or so and still has to be on them (sometimes he reduces them to 1/day)
- Another one struggled with it for a year or so .. and then when he changed his job - which reduced his stress and he got better and he hasn't had it since
- A relative of mine gets it for a few weeks/months - then it disappears for a few months and it then it comes back with such triggers as viral, cold, stress etc. (this has been happening for 10 years or so for him)

So .. I guess there is no clear answer - and it does depend on the cause and whether the muscles/nerves of / around the LES can somehow get back to their normal functioning. Since I can not take drugs (ppis/h2s), I've started to practice yoga, meditation and breathing exercises in all earnestness .. which is definitely helping me .. but I am by no means asymptomatic .. but the frequency and the intensity of my symptoms has been coming down in the last 2-3 months. I do get some days and some parts of the day when I don't feel the symptoms .. so I am hopeful ..
Posted 11/12/2011 3:06 AM (GMT 0)
Liz,

Speaking from my own experience the answer is yes.  When I first was treated for GERD I was well controlled on 20mg Prilosec once a day before dinner.  As years went on my GERD worsened and I moved to 20mg twice a day, then 40mg Nexium twice a day, then after a hospitalization with GERD related asthma I was switched to 40mg Prilosec twice a day and 300mg Zantac at bedtime.  Finally, I had the Nissen surgery.

Listening to stories from my friends, it sounds like my progression from bad to worse isn't unique.

Good luck in your quest!

Denise

Posted 11/12/2011 7:26 AM (GMT 0)
Hey Liz,

I'm sorry love, I was having a horrible day yesterday and I focused so much on the bad that I forgot about the good!

I am developing new symptoms, BUT - my GERD before I started Nexium and lost all my weight was terrible. Heartburn that kept me up on the couch all night and sent me to the ER twice was just more than I could handle. Since I started the Nexium, diet and exercise, my symptoms have shrunk down to occasional bloating (no actual heartburn, thank goodness) and some strange right-sided pain (we still haven't figured that one out, LOL).

The acid burping has only happened when I'm in an inverted position, so I should be pretty happy about that since I'm only upside down a few times a week at Yoga. Besides that, I have had many positive changes in my symptoms. So while yes, it is technically getting worse (with the arrival of the nausea) it is also a thousand times more manageable.

However, I'm still hoping for the surgery. LOL!

I hope this helps!
Ashley
Posted 11/13/2011 1:53 AM (GMT 0)
I think it depends on the person. Some people do great on PPIs, some can't tolerate them at all, and some can manage without them. If you have an open LES, the highest dose of PPIs won't help but surgery will. I've had 3 nissens and digest just fine. :)
Posted 11/14/2011 11:35 PM (GMT 0)
"does gerd usually worsen over time?"

i can only speak from my experience..yes and no!

my GERD got slowly...slowly.... progressively worse during the last 30 years...but nothing i couldnt handle with baking soda, calcium carbonate etc

then in the last 10 years i needed H2s..... and then PPIs... neither of which could i tolerate very well

in the last few years ago i noticed i had lung congestion almost all the time...but hey it wasnt all that bad...but then...so i coughed a lot ( no i dont smoke)

then almost two years ago i fell off a cliff...so to speak,,,, and the gerd turned into a living hell

i was inhaling reflux at night, my lungs were a mess and my upper esophagus felt like it was on fire

i learned i had LPR but it took 6 months of testing and trying things

with diet exercise and occasion use of meds but most importantly sleeping very inclined and loosing weeight...i got better...not as better as i was 10 years ago but i was better than a year or two ago

so

does GERD always get worse? not necessarily...seems to me the general trend is down ...but if you act with resolve one can often pull back and make some improvements

note, im old.... young people heal better and have good reason to hope!

best wishes
mt
Posted 11/15/2011 2:28 AM (GMT 0)
Ha!
Mock Turtle,
You are cracking me up over here with the "I'm old" business.

Well...seems like the general consensus is that the GERD is slowly progressive. I'm not too happy about that. Makes me a little afraid to think about my future. It's hard to get this whole thing off of my mind now even despite the off-and-on nature of my symptoms with or without meds. I think I'm still in a bit of denial since just 7 months ago, I could eat whatever I pleased. I've always had a strong stomach. Until now, I'd only had heartburn twice that I can remember...in my whole life. I guess there's always the Nissen but I know the road to surgery will be paved with worsening and waiting for this test and that to make sure I'd be a candidate, etc.

If only there were some way to strengthen the LES. It's a muscle right? Wish I could just do some curls and whip that thing into shape :)

Peace,
Liz
Posted 1/3/2012 4:33 AM (GMT 0)
Just got this forum.. Incredible information.

Suffering from GERD and want to get rid of the PPI. I have started yoga. Not sure if it will heal things but atleast after about a week or so feeling much better. I normally would take a PPI in once in about 3-4 days but I am now suffering badly from the bloating / gas and want to stop PPIs altogether.

keep you posted on progress.
Posted 1/3/2012 9:02 AM (GMT 0)
Welcome to Healing Well ...

Take care playing fast and loose with the ppis - acid rebound can be a problem if you stop and start them!

MMM
Posted 1/3/2012 3:33 PM (GMT 0)
Hi BT,

I second MMM's welcome to Healing Well!  Glad you've joined us.  I don't think that taking PPI's only occasionally and for a few days will cause you any rebound.  However, generally Ranitidine/Zantac is used for shorter-term cases.  Have you tried that?  PPIs are great and do work better than Ranitidine, but it takes a week or so for them to be at full potency. 

My daugher-in-law who's a PA takes Protonix (PPI) from time to time--only when she needs it--so she's comfortable using it that way and is certainly knowledgable regarding its usage.

Again, glad you've joined the forum!

Best wishes,

Denise

Posted 1/3/2012 5:07 PM (GMT 0)
In my previous posts i am a strong beleiver in that PPIs makes more harm than good, i have witnessed how much side-effects those pills contributes to the situation, i have been off PPIs now for 1month soon, before i had to work hard with all rebound effects and constipations when i took these PPIs.
I would not be surprised if all new symtoms some people get are caused by PPIs.

I can also say i have got inflammaton in top of my right foot after taking Nexium for 5 days, it hasn't healed yet and i don't know when but i do know for sure it's caused by Nexium.
Posted 1/3/2012 5:12 PM (GMT 0)

dencha said...
Hi BT,. I don't think that taking PPI's only occasionally and for a few days will cause you any rebound.
Best wishes,
Denise

It does cause rebound, i have been having terrible rebounds after just taking for 2 days as i can't tolerate the side-effects so i could only take 2-3 days at a time, once i took Nexium for 5 days but that was horrible.

The rebound comes after 2 days with me after i stopped any PPI.

Last time i took PPI was about 1 month ago, i had a terrible 3-5 days with rebound and i've been very fine now without them, PPI's are poison in my opinion as they also cause CNS side-effects in some people like me.

Doctors take wrong approach in healing GERD, the problem is not the acid, the problem is mechanical and caused by overweight, it can also be caused by anxiety which is proven by some people in this forum who takes Lyrica and have been cured, there are many other factors for every individual that causes GERD, when most doctors only prescribe PPIs to people they don't want to get to the bottom of this horrible problem many people have as PPIs cause so many new problems with many they are not aware of.

Yes i have soar throat which gets less for each week now, the gastritis is under control now when i don't take PPIs, my white tongue is almost normal now with red/pink color after stopping PPIs

Post Edited (lanab) : 1/3/2012 10:20:16 AM (GMT-7)

Posted 1/3/2012 11:14 PM (GMT 0)
lanab-

This the way the PPIs affect you. Not the way they affect everyone. I have taken PPIs for several days and stopped them all at once and not experienced any rebound. In fact I have never tapered off PPIs and have never experienced rebound. Can I say this is a general experience for everyone? No, just for me.

I hope you have continued success controlling you GERD.

Take care,
Bill
Posted 1/20/2012 9:50 AM (GMT 0)
"Evolution of Gastro-oesophageal Reflux Disease Over 5 Years Under Routine Medical Care"
http://www.medscape.com/viewarticle/755973?src=mp&spon=20

Here's a link to a very recently published article - main take home point is that GERD tends to be stable over a 5 year period in most people. Some get better, a few will get worse, but mostly things level out. The authors conclude this to mean that treatment strategies currently in use are therefore adequate. It's a German study following up around 6000 patients and I think it provides a good answer to this thread's original question!!

MMM
Posted 1/20/2012 8:03 PM (GMT 0)
Both my parents have had a symptomatic hiatal hernia; and a half brother has one as well (genetics anyone?)

and about two months ago I also got one (at age 27...), probably due to heavy lifting, but anyways... I'm learning to live with GERD.


My dad has been on omeprazole since I can recall, and he seems stable. For sure his lifestyle hasn't been affected further. He is 76 now.

My mom was on omeprazole and I remember when I was in high school that she would complain a lot about acid reflux (back then I didn't understand how reflux could change your daily life so much!). In her case she has improved A LOT. She doesn't need omeprazole anymore and she can sleep flat without problems. Fatty foods or eating late still give her problems but nothing compared to those earlier years.

My half brother, he was very overweight and his reflux virtually disappeared once he lost weight.

Of course it depends from person to person, but I do believe it stabilizes over time. At least that's the evidence I've seen inside my own family.


In my case I'm not obese (I would say I'm on the very underweight side now... my colleagues joke that I have the face of Tom Hanks in the movie Philadelphia :)) ; and maybe its too soon to say if it gets better or worst.
It seems nexium 40 is giving me enough relief to heal and I can swallow again. yay. .

I'm trying to to my part.. I sleep on a reclined bed, I don't like alcohol nor chocolate, but i loved citrus fruits and carbonated drinks and I've had to drop them. And I feel better than when all this started and had to go to the hospital. I lost 20 pounds in less than two weeks due to the enormous pain. My doctors got a bit alarmed because I was already on the 'fit' side of the scale. I was very scared ... but at least back then the logic part of my brain was showing me that, from my family's experience, chances were that it was not going to get any worst than that.
Posted 1/20/2012 8:45 PM (GMT 0)
MMM,

thank you for the link to the medscape article. Gives me hope that I won't be going downhill anytime soon. I am definitely getting good symptom control / relief with the Prevacid 24HR as I have for the past 4 months now. Occasionally though I fall victim to fear that it will suddenly stop working for me but I have to just push those negative thoughts out of my mind and keep pressing on. I often wish I had never even heard of "GERD". Blah.

-Liz-
Posted 1/20/2012 9:37 PM (GMT 0)
You're welcome Liz - glad you're doing OK. Yes keep those dark thoughts out - I think my GERD thrives on my bad thoughts so I'm giving up being a full time mum in favour of keeping my thoughts elsewhere and my hand out of the biscuit tin!!

MMM
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