What Is GERD?
Reviewed by: HU Medical Review Board | Last reviewed: September 2019 | Last updated: February 2021
Acid reflux, or gastroesophageal reflux disease (GERD) is one of the most common complications of cystic fibrosis (CF). It’s important to control GERD so that the person with CF does not associate eating with pain and can get enough calories to stay healthy.
What is GERD?
The stomach makes acid to break down the food we eat. If this acid moves up from the stomach into the esophagus, it creates heartburn and discomfort. This is called acid reflux or gastroesophageal reflux disease (GERD). Over time, the acid can damage the esophagus, or trigger coughing and asthma.1
Several studies have found that GERD is associated with more severe lung disease with lower pulmonary function and an increased number of exacerbations in people with CF.2
How common is GERD in people with CF?
Acid reflux is a gastrointestinal complication of CF found in 36.1% of those 18 and younger, and 39.6% of those 19 and older.3
GERD becomes more common as people with CF age, with approximately 50-60% of those ages 50 and older reporting GERD. People with CF who have a mutation class I-III are more likely to develop GERD than people with mutations from class IV-V.3
One study reported that 91% of those awaiting a lung transplant had evidence of GERD, and 90% of people with CF who had undergone a lung transplant had GERD.
Medications for GERD
Many drugs can be prescribed for acid reflux. These medicines help control the GERD and help pancreatic enzymes (PERT) work better by reducing the amount of acid in the stomach. These drugs include:
Proton pump inhibitors
- Omeprazole (Prilosec®)
- Lansoprazole (Prevacid®)
- Esomeprazole (Nexium®)
- Ranitidine (Zantac®)
- Famotidine (Pepcid®)
- Nizatidine (Axid®)
Proton pump inhibitors are prescribed more often than H2 blockers in adults with CF, while H2 blockers are used more frequently in children. For people with CF ages 20 and older, 55.7% take proton pump inhibitors.2
Over-the-counter antacids, such as Rolaids®, Maalox® or Mylanta® may be used with proton pump inhibitors, but not alone to treat acid reflux.
Other treatments for GERD
Dietary changes may also help control acid reflux. These changes include:
- Eating smaller meals, more frequently
- Not eating big meals just before laying down to sleep
- Avoiding spicy foods, alcohol, caffeinated and carbonated drinks, and mints
Some people find that slightly propping up the head of their bed helps since their body angles down while sleeping.
Occasionally, people with severe GERD may need surgery to tighten the muscle where the esophagus meets the stomach.