reflux esophagitis

  I am a 32 year old woman who was diagnosed with reflux esophagitis in 1993. I was scoped twice to determine if I had an ulcer and both times nothing was found. I was started on Zantac then switched to omeprazole after a month. I was on this for about 4 years with minimal relief of symptoms. I was then switched to prevacid three months ago, 60 mg qd and was told that I will have to take it for the rest of my life. My question is: does anyone know the long term side effects of this drug and will I eventually have to have surgery to get relief?

Dear Lorna,
Concerning your query about long-term lansoprazole (Prevacid) therapy, one can only extrapolate from the experience with omeperazole (Prilosec). Both medicines belong to the category of medications called proton pump inhibitors (PPIs). Omeperazole (Prilosec), when first introduced in this country, was only approved for short periods because of the possibility of developing rare stomach tumors called carcinoid tumors due to prolonged acid suppression. These tumors developed in rats given very high doses of omeperazole (Prilosec). However, omeperazole (Prilosec) has since been used in Europe in patients
with ulcers and gastroesophageal reflux for several years at a time without adverse effects. Therefore, it is currently prescribed in the United States for prolonged periods. In my clinical practice, I try to use lowest dose of omeperazole (Prilosec) or lansoprazole (Prevacid) necessary to control symptoms and try to wean patients off of the drug whenever possible. On the other hand, I will prescribe these medications for longer periods as necessary if clinically warranted.  If you do not obtain relief with lansoprazole (Prevacid) you might want to consider surgical management. You  should undergo further testing prior to surgery to confirm the diagnosis of GERD and to rule out other esophageal motility disorders. You should also be aware that any surgical procedure has associated risks. You should consider the risks, benefits and alternatives of any procedure prior to proceeding with surgery.I hope you find this informationhelpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: lansoprazole (Prevacid), long-term use, medical vs. surgical management, gastroesophageal reflux disease