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Kristin Hayes, R.N.

Are Your Acid Reflux Medications Predisposing You To Eosinophilic Esophagitis?

By September 10, 2009

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Very little is known about eosinophilic esophagitis. It seems to be an emerging illness that has just been discovered in the last decade or so. Scientists believe the disease to be related to food allergies. My brother was finally diagnosed with the disease after years of acid reflux problems. We were surprised when he went to an allergist and found that he had no food allergies. Another interesting theory is that acid reflux medication is actually causing the food allergies that are responsible for eosinophilic esophagitis (EE). It can also be difficult to differentiate symptoms of eosinophilic esophagitis and GERD.

According to The American Journal of Gastroenterology, the medications people are receiving for the treatment of GERD may have a role in the development of new food allergies and pose a possible link to the increase of eosinophilic esophagitis in the last decade. The medications that are mostly prescribed to treat GERD belong to a class called Proton Pump Inhibitors (PPI). The most commonly prescribed PPIs include: Aciphex (rabeprazole), Nexium (esmoprazole), Prevacid (lansoprazole), Prilosec (omeprazole), and Protonix (pantoprazole).

PPIs can be a protective treatment in acid reflux, ulcers and other disorders associated with the stomach. These medications prohibit the generation of acid along the proton pumps that pump acid into the stomach. By blocking this channel, the pH in the stomach increases becoming more basic.
However by changing pH in the stomach, some studies have shown that certain food allergens are no longer degraded as they would be without the use of a PPI. Other studies are showing that the intestinal lining may also become more permeable with the use of PPIs which may allow for easier absorption of these food allergens.

But don't stop taking your PPI just yet. While these studies have shown some links between PPI use and the development of food allergies, followed by an immunologic reaction that could lead to eosinophilic esophagitis, there needs to be further studies and testing performed before a cause and effect link can be fully established. Besides, untreated acid reflux is also a precursor for Barrett's esophagus and esophageal cancer. These two illnesses could easily be considered more dangerous than eosinophilic esophagitis.

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