Is Ozempic Exacerbating Your Heartburn?

Is ozempic exacerbating your Heartburn

Is Ozempic Exacerbating Your Heartburn?

Mary from Houston sent us this question: “My PCP started on Ozempic 3 months ago for my type 2 diabetes. My blood sugar control has improved but my heartburn has gotten worse. I can no longer control my acid reflux symptoms with daily Protonix. I wake up at night with food regurgitation despite elevating the head of my bed. My PCP has recently double my Protonix dose, but I don’t think it is helping me a lot”. Thank you.

Dear Mary,

GLP-1 agonists like Ozempic, Wegovy, Mounjaro and Zepbound are commonly used now for treatment of diabetes and obesity. GLP-1, (glucagon like peptide-1), agonists delay gastric emptying. The most common side effect of delayed gastric emptying is nausea. Around 20% of patient on Ozempic experience nausea. Vomiting and abdominal pain occur in 10% of patients taking Ozempic. Furthermore, delayed gastric emptying favors acid reflux. Consequently, patients who are already on proton pump inhibitors for acid reflux control, may experience worsening heartburn and food regurgitation after starting Ozempic.

The spectrum of acid reflux disease is wide. GERD patients are divided into 4 stages. Stage 2 GERD patients have frequent or constant symptoms that are well controlled with medications like proton pump inhibitors. Stage 3 GERD patients experience breakthrough symptoms despite daily acid suppressant treatment. In your case, Mary, the addition of Ozempic to control your blood sugar upgraded your GERD from stage 2 to stage 3.

Surgical therapy in the form of a properly performed hiatal hernia repair and Nissen fundoplication is indicated for stage 3 GERD patients. Once the anti-reflux barrier is restored, patient can safely resume Ozempic treatment without struggling with any GERD related symptom like heartburn and food regurgitation. Another option for diabetic or overweight patients with concomitant acid reflux is to undergo a bariatric procedure in addition to hiatal hernia repair. This approach is both safe and reliable to control blood sugar, lose excess weight, as well as eliminate GERD related symptoms and the need to continue Ozempic for life.