I am a 27 y.o. male with GERD. I showed a small hiatal hernia but no esophagitis during an endoscopy in 2019. I have been on lansoprazole 30mg daily for probably about a decade at this point and it has been a game changer. I can eat pretty much whatever I want (I still try to eat a relatively healthy diet) with little chance of heartburn. Typically I only get any heartburn unless I eat something very spicy and even then it’s mild.
I have been given some conflicting advice about whether I should continue taking the lansoprazole given I’m otherwise healthy and it works very well to control my symptoms. During my last visit with my primary care doc her attitude was that I’m fine to continue taking it for now but there could be concern if I continue taking it indefinitely. The studies I’ve seen seem to support that conclusion. I was just hoping to glean some insight or potentially get some resources as I’d prefer to continue the medication if possible but I’m open to trying an H2 blocker (which she also wrote a prescription for) if possible. I am trying to tighten up some areas of my diet but avoiding caffeine, alcohol and spicy food completely is a tall order at this point in my life.
There are some known risks to being on these meds long term, although they are typically lower compared with the risk of developing complications of chronic, uncontrolled reflux/esophagitis such as esophageal cancer.
If there is a lifestyle-based strategy that allows you to eliminate symptoms, that is also tolerable and sustainable for you (in other words … it’s something you’re actually willing to do long-term), then that would be preferable to being on indefinite PPI therapy. If, on the other hand, you are not willing to do those things indefinitely (which is understandable), or if there is no strategy that allows you to achieve remission of symptoms, then continuing the medication would be an acceptable alternative, particularly compared with the risks of chronic uncontrolled reflux. If you can keep symptoms controlled with H2 blocker use, that’d be acceptable as well.