Your medications could be making your acid reflux worse.
Acid reflux, which is usually heralded by heartburn, is unpleasant enough when it occurs only occasionally. For up to 20 percent of American adults, acid reflux is a frequent occurrence that significantly diminishes their quality of life. Obesity, diet, smoking and a variety of other factors have been linked to acid reflux, and your physician may have urged you to address some of these issues. However, if you have not reviewed your medication list, you may be missing a key element in your treatment plan.
Blood Pressure Medications
The muscles of your lower esophagus - the lower esophageal sphincter - are able to maintain their tone and prevent reflux by controlling the flow of calcium through microscopic channels in their cells' membranes. When these calcium channels are blocked, the LES becomes less efficient, and acid reflux occurs more readily. Calcium channel blockers, such as diltiazem (Cardizem, Dilacor), nifedipine (Adalat, Procardia) and amlodipine (Norvasc), all of which are commonly prescribed for high blood pressure, may aggravate acid reflux. Other less commonly prescribed blood pressure medications that can trigger reflux include alpha-adrenergic agonists, such as clonidine (Catapres) and guanfacine (Tenex).
Beta agonists are among the most widely prescribed drugs for people with asthma or chronic bronchitis. These medications, which include albuterol (Ventolin, Proventil), pirbuterol (Maxair) and salmeterol (Serevent), attach to receptors in the LES and decrease its tone, thereby permitting more frequent episodes of acid reflux.
Other commonly used drugs that treat lung problems and can aggravate reflux include anticholinergic agents, such as ipratropium (Atrovent) and tiotropium (Spiriva). Anticholinergic medications have a broad range of non-asthma uses, too. Some, such as benztropine (Cogentin), are only available by prescription. Others, such as dextromethorphan (Robitussin DM and many others), diphenhydramine (Benadryl), dimenhydrinate (Dramamine) and chlorpheniramine (Chlor-Trimeton), are available over the counter. All of these drugs can trigger episodes of acid reflux.
Nervous System Drugs
A wide array of medications used for treating depression, anxiety, nicotine habituation, Parkinson's disease, urinary incontinence and other nervous system disorders may aggravate acid reflux. These agents interfere with LES function through various mechanisms, but they all may ultimately increase the frequency or severity of reflux episodes. Bupropion (Wellbutrin, Zyban), levodopa (Sinemet, Larodopa), diazepam (Valium), alprazolam (Xanax) and oxybutynin (Ditropan) are representative examples.
Many women who have gone through pregnancy know how troublesome acid reflux can be. While most women attribute pregnancy-related heartburn to a rapidly growing fetus, that is only part of the story. Hormones, particularly progesterone, cause relaxation of the LES and make acid reflux much more likely to occur. Thus, women who take hormone replacement therapy to deal with menopausal symptoms may find themselves struggling with acid reflux, as well.
According to a study published in the July 2011 issue of the "Journal of Pharmacology and Experimental Therapeutics," your lower esophageal sphincter is a complex muscular mechanism whose cells are studded with receptors that can respond to many chemicals. The list of medications, both prescription and over-the-counter, that can attach to these receptors is expansive. Check with your physician or pharmacist to determine if any of the medications you are taking could be contributing to your acid reflux symptoms.