Gastroesophageal reflux disease, commonly called GERD, is the occurrence of stomach acid entering the esophagus two or more times per week. This is caused by the lower esophageal sphincter (a band of muscles between the esophagus and stomach) spontaneously opening and allowing the stomach contents to enter the esophagus. This causes irritation and inflammation of the lining of the esophagus, triggering symptoms such as heartburn, cough, asthma and trouble swallowing. Certain prescription medications can aggravate GERD by affecting the esophageal sphincter or damaging the esophagus.
Anticholinergics
Anticholinergics are a group of medications that block acetylcholine (a chemical that allows nerve cells to communicate with each other) in the central nervous system. Their main function is to relax muscles. This makes them effective in treating respiratory problems, as they relax the muscles in the bronchial tubes that open the airways. They are also effective in treating bladder disorders, as they reduce bladder contractions.
For people with GERD, anticholingerics can aggravate their incidence of reflux. The medication acts on the esophageal sphincter, causing it to relax and allowing reflux.
Sedatives or Tranquilizers
Sedatives such as benzodiazepines (Valium) are prescribed for their calming effects. Sedatives are often given to treat anxiety disorders, nervous system disorders and sleep disorders. Low doses of sedatives can help treat coughs, nausea and convulsions, while high doses can be used as anesthesia.
Sedatives slow the activity in the brain and cause muscles to relax. This includes the muscles of the esophagus sphincter, which when relaxed allows the reflux of stomach acid.
Calcium Channel Blockers
Calcium channel blockers are medications that work to block the entry of calcium into muscle cells. These medications are used to treat high blood pressure, heart arrhythmia and atrial fibrillation, because blocking calcium from the cells decreases the contractions of the heart muscle.
These medications can also act on other muscles, including the muscles of the esophagus, decreasing their ability to contract. This affects the efficiency of swallowing as well as the esophageal sphincter's ability to block reflux.
Narcotics
Narcotics, such as opioids, codeine and hydrocodone, are often prescribed for acute and chronic pain. Narcotics work by attaching to specific proteins on the brain, spinal cord and gastrointestinal tract to interfere with the transmission of pain signals to the brain. They also act on the brain to alter the perception of pain.
Narcotics can damage the tissues in the esophagus, which can aggravate the symptoms caused by GERD.
