Ibuprofen may increase symptoms of gastrointestinal reflux disease (GERD). If a person with GERD needs to take pain relief medication, their doctor can advise on suitable alternatives.

Ibuprofen is a type of nonsteroidal anti-inflammatory drug (NSAID). It can provide both pain relief and anti-inflammatory effects.

GERD is a condition where the contents of the stomach move back up the esophagus, or food pipe, causing symptoms such as regurgitation, nausea, bloating, or discomfort.

This article reviews what we know about the relationship between ibuprofen and GERD and other possible medications that can cause GERD. It also discusses medications to help with GERD.

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Some studies show an association between NSAID use and either an increase in GERD symptoms or the development of GERD.

According to a 2017 review, NSAIDs have links to both direct and indirect damage to the mucus in the digestive tract. Effects of NSAIDs include:

  • increasing gastric acid secretion
  • inhibiting cyclooxygenase (COX) enzymes
  • delaying emptying of the stomach
  • reducing lower esophageal sphincter pressure

The review also noted that taking NSAIDs, such as ibuprofen, when living with GERD can increase symptom severity.

In an older study from 2008, researchers noted that NSAIDs increase a person’s risk of GERD symptoms.

Using NSAIDs may also increase the risk of other gastrointestinal (GI) complications. An older study from 2013 noted that people who take NSAIDs regularly have a 4–5-fold higher relative risk of developing peptic ulcers.

Evidence suggests that people with GI risk factors need to avoid using NSAIDs. Additionally, the authors state that doctors should consider the benefits versus risks before prescribing or recommending these medications in at-risk populations.

Learn about the risk factors for GERD.

Other medications may also increase the risk of developing GERD or worsen symptoms in existing cases.

Some medications a person with GERD may want to avoid include:

Before stopping a medication, a person can discuss this with a doctor. They may be able to advise on alternative medications.

A doctor may recommend acetaminophen (Tylenol) if a person with GERD needs to take pain relief medication. Acetaminophen is a common type of pain reliever available in both over-the-counter (OTC) and prescription forms.

In a 2014 study, researchers suggested that NSAIDs and acetaminophen work on the same gene relating to gastric damage. NSAIDs helped activate the gene expression, while acetaminophen helped suppress its action.

However, acetaminophen may not work well for everyone. High doses or taking too much can lead to liver failure. A person needs to follow all dosing instructions and contact a doctor before taking medication.

Medications for GERD typically include antacid antisecretory agents, such as proton pump inhibitors (PPIs) or histamine receptor antagonists (H2RAs).

In general, PPIs provide the best medication for GERD. Currently, in the United States, a person may use one of six types of PPIs.

Three OTC forms include:

  • esomeprazole
  • lansoprazole
  • omeprazole

Doctors can also prescribe three other forms of PPIs, including:

  • pantoprazole
  • rabeprazole
  • dexlansoprazole

A person can also find H2RAs over the counter in two forms: famotidine and cimetidine.

In addition to medication, a person may consider making some lifestyle changes to help manage GERD. This can include weight management, avoiding large meals before bedtime, and making dietary changes.

The following are answers to common questions about using NSAIDs for GERD.

Can anti-inflammatories cause GERD?

Studies suggest that NSAIDs can damage the upper and lower GI tract. A person with GERD or at risk of the condition needs to discuss using these medications with a doctor before starting on them. These drugs may irritate or worsen symptoms or increase the risk of developing the condition.

What is the safest NSAID for GERD?

Some evidence suggests that certain NSAIDs may be safer for GERD. An older review from 2010 noted that faster-acting NSAIDs and COX2 subtypes may be generally safer compared to medications with a slow release.

A person with GERD needs to discuss alternative pain relief options with a doctor before taking any NSAIDs, as they all carry some risk of GI damaging effects.

What foods neutralize stomach acid immediately?

Some foods that may help with stomach acid include those that are alkaline, such as yogurt, milk, kefir, and cottage cheese. Consuming a diet rich in fruits, vegetables, and whole grains may help reduce acid reflux in the long term.

Learn more about foods to eat with GERD.

Ibuprofen and other nonsteroidal anti-inflammatory drug (NSAIDs) will likely worsen or trigger gastrointestinal reflux disease (GERD). A person’s doctor can advise on suitable alternatives if a person with the condition needs to take pain relief medication.

Acetaminophen may be a suitable alternative for pain relief for some people. However, a person needs to follow a doctor’s dosing instructions when taking pain relief medication.

In addition to avoiding NSAIDs, someone with GERD may benefit from acid-reducing medications and lifestyle changes, such as weight management and changes in diet.