GERD Long-term Treatment Risks

GERD: A Common but Serious Condition

Nearly 20 percent of Americans suffer from regular bouts of heartburn, acid indigestion and other symptoms of chronic gastroesophageal reflux disease (GERD).  A fortunate few find relief through lifestyle modifications such as losing weight, avoiding certain foods, elevating the head of the bed and not eating within three hours of going to sleep, among others. But many more must turn to medication to tame that burning, painful sensation.

For the last two decades, the most popular and effective GERD medicine on the market, both prescription and over-the-counter, has been a class of drugs called proton pump inhibitors (PPIs).

“The original PPI was first approved in the United States in 1989 for the short-term treatment of ulcers,” explains Timothy Koch, MD, a gastroenterologist and bariatric specialist at MedStar Washington Hospital Center. “When doctors saw how well it worked on the symptoms of ulcers, they started to wonder if PPIs would be effective for persistent heartburn, as well.”

As everyone now knows, the answer was a resounding “yes.” But more recently, scientists have been asking, “For how long?”

“Over the last few years, there have been many studies looking at whether long-term PPI use contributes to gut infections, bone loss, chronic kidney disease and even dementia,” Dr. Koch says.  “While findings suggest an association, we don’t have any definitive answers yet.”

Untreated GERD can damage the food pipe, and contribute to Barrett’s esophagus, a risk factor for esophageal cancer, so it’s important not to ignore.  

“Through endoscopy and other specialized studies we can look for scar tissue and other irritation, measure problems with swallowing, and otherwise evaluate each patient to see if there is another cause of their discomfort…and possibly an alternative to long-term PPI treatment,” he adds.

As a precaution, Dr. Koch recommends that people who have been taking more than one PPI a day for many years seek a thorough medical re-evaluation to see if they still need—and are benefitting from— the medication.

Listen in on Dr. Koch's full interview. 

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Dr. Timothy Koch

Timothy Koch, MD
MedStar Washington Hospital Center

For an appointment, call 202-877-3627.


Safe Solution to Hearing Loss for People with Dementia

Improved Hearing May Decrease, Delay Dementia

Over the last few years, medical researchers made an interesting discovery: Severe hearing loss, in and of itself, contributes to and worsens cognitive decline and dementia among the elderly. While the chicken/egg relationship is not exactly clear—nor the mechanics of how or why—the effect is circular, with one condition feeding upon the other. Both lead to frustration, social withdrawal, depression and anxiety, causing many elderly patients to lose the ability to communicate with or understand the family, friends and others who love and care for them.

But a 2015 study in JAMA Otolaryngology-Head & Neck Surgery demonstrated marked improvements in thinking and memory skills after hearing- and cognitive-impaired patients received a sophisticated type of hearing device, a cochlear implant.

So why aren’t more patients with both dementia and profound hearing loss receiving the same treatment? The answer may lie in the procedure itself.  

“Typically, a patient undergoing a cochlear implant receives general anesthesia,” says Selena Heman-Ackah Briggs, MD, a head and neck surgeon specializing in hearing loss and ear disease at MedStar Washington Hospital Center. The Hospital Center was the first and, for many years, only site in the metropolitan area to offer cochlear implants for adults. “Yet anesthesia is a known risk factor for patients who are already experiencing cognitive decline, especially if they also have other problems like heart or lung disease.”  

To resolve the dilemma, Dr. Briggs began substituting local sedation for her elderly cochlear implant patients.

“The milder anesthetic lets patients rest comfortably and breathe on their own during the ‘twilight’ procedure, while reducing the risk of complications,” she says. “In-hospital recovery time is cut almost in half, with patients going home the same day.”  

Unlike traditional hearing aids which merely amplify sound, cochlear implants rely upon a sophisticated system of microphones, speech processors, transmitters and other complex parts to interpret and convey electrical impulses directly to the brain. As such, recipients must go through training sessions with audiologists to learn how to “hear” with their new device.

Despite their age, patient response has been remarkable, according to Dr. Briggs.

“Most of my elderly patients are just so excited about being able to hear again,” she says. “Through cochlear implant, we’re restoring their ability to communicate, to be active and functional, and stay in the game of life.”   

To listen to Dr. Briggs’s full podcast interview, click here.

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As heard on WTOP Radio:

Selena Heman-Ackah, MD

Selena Heman-Ackah Briggs, MD
MedStar Washington Hospital Center

For an appointment, call 202-877-3627.