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Gastroenterology (Expert Forum)
meds for gastric reflux
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
meds for gastric reflux
by Jan__0__0, May 28, 1998 12:00AM
My husband has had Barretts for 8 years and has an endoscopy every 2 years to assess malignancy. No malignancy has been evident. He has watched his diet and alcohol intake and has been on the Rx Pepcid (40mg.) 2x daily for the 8 years. This has been quite successful in controlling the symptoms.
His Internist recently prescribed Prilosec and said if it was successful he might take him off the Pepcid. I understand that Pepcid is an acid blocker and the Prilosec is a neutralizer. What is your opinion regarding this change.
my husband would like to discontinue the Pepcid as we heard recently that long term use could affect testosterone level and my husband has experienced evidence of that. any comments on this?
Thank you for your help
____________________
Dear Jan,
The cause of Barrett’s Esophagus is unclear, but current theory attributes the mucosal change to chronic exposure to gastric acid. The treatment of Barrett’s esophagus, therefore, is directed towards suppression of gastric acid secretion.
Gastric acid secretion suppressants include proton pump inhibitors such as Prilosec and Prevacid, and H2 receptor inhibitors such as Pepcid, Zantac, Axid and Tagamet. Prilosec and Prevacid are more potent suppressors of acid production than the H2 receptor inhibitors. Therefore, Prilosec and Prevacid would be the treatment of choice in reducing gastric acid secretion. However, higher than usual dose of Pepcid (40 mg bid) as your husband has been received, may also achieve the same gastric acid suppression effect.
Currently, there is no published data or literature to indicate that long term use of Pepcid would affect male testosterone level or its biological function. If your husband has experienced sexual dysfunction, we recommend that he see his internist or endocrinologist regarding this issue.
Why do patients with Barrett;s esophagus require repeated upper endoscopy? Endoscopic surveillance is necessary because Barrett’s esophagus can develop into a malignant neoplasm of the esophagus. Detection of early changes suggesting evolution into cancer will allow for treatment to be initiated.
The information provided are for educational purpose only. Always ask your personal physician specific questions regarding your medical consitions.
HFHSM.D.-rf
*keywords: Barrett’s esopahgus, protonpump inhibitors, acid suppression
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