In managing gastro-oesophageal reflux disease, if a prescription drug is suspected of exacerbating symptoms, what is the recommended approach?

• A. Review and stop medicines that may exacerbate symptoms
• B. Ignore symptoms and continue current therapy
• C. Increase the dose of the suspected drug
• D. Switch to a higher-risk alternative without review

Answer: (B)

When symptoms of gastro-oesophageal reflux disease seem to be worsened by a prescription drug, the first step is to review the patient’s full medication list and identify any agents that could be contributing to reflux or irritating the esophagus. If possible, stop or replace those medicines with safer alternatives and recheck symptoms, ideally in collaboration with the prescriber. This approach aims to remove the potential trigger rather than simply treating symptoms while leaving the offending drug in place. Ignoring the symptoms would miss the chance to address the underlying cause and could allow reflux to persist or worsen. Increasing the dose of the suspected drug or switching to a higher-risk alternative without review could heighten risk and harm the patient. The goal is to minimize exposure to any drug that worsens reflux while maintaining overall disease control.