Does Amitriptyline Help With GERD? (+3 Treatment Options)

By Ivan Kahwa

Page last updated: 02/02/2024 | Next review date: 02/02/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

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In this article, we will explore whether amitriptyline can help with the treatment of GERD or not, how amitriptyline helps with GERD and what are the available treatment options for GERD.

Does amitriptyline help with GERD?

Yes, amitriptyline can help with the treatment of GERD (Gastroesophageal reflux disease). Amitriptyline does not directly treat the condition of GERD but it can help with a few of its symptoms. It is combined with acid-lowering medications to treat GERD.

It can help with oesophageal hypersensitivity and can improve sleep quality. These symptoms can indirectly alleviate GERD conditions.

Amitriptyline is an antidepressant that belongs to the class of tricyclic antidepressants (TCAs). This drug has been used for decades to treat psychological conditions such as depression, anxiety and in some cases chronic pain (1). The pain-relieving characteristic of amitriptyline can also be helpful in the case of GERD (2).

If you have GERD, then instead of self-prescribing amitriptyline, it is essential to consult your healthcare provider to help you with the condition alleviate the symptoms and manage them.

How does amitriptyline help with GERD?

Amitriptyline can be helpful for GERD in some cases. Amitriptyline is used for the management of stress and anxiety (3). By reducing stress and anxiety, amitriptyline helps with regurgitation and heartburn, symptoms of GERD (4).

Amitriptyline also has pain-relieving properties due to its action on certain neurotransmitters including norepinephrine and serotonin in the brain. It blocks the reuptake of these neurotransmitters and modulates the perception of pain in patients taking it, especially those with oesophagal hypersensitivity. This can help with the chest pain observed in some patients with GERD (2).

Sleep problems are often associated with people having GERD (5). Amitriptyline has sedative properties that can be attributed to (1):

Inhibition of reuptake of serotonin and norepinephrine
Antagonistic activity on H1 receptors
Alpha-adrenergic blocking properties

These mechanisms result in a calming effect on the patients having GERD issues. This improves sleep quality, reduces stress and promotes relaxation.

What does the research suggest?

Amitriptyline has been used as a combined therapy with some other medications that help treat GERD. These medications include proton pump inhibitors (PPIs) and H2 receptor antagonists.

Amitriptyline, when combined in low doses with conventional doses of PPIs or H2 receptor antagonists has proven to be helpful in treating GERD symptoms with reduced adverse effects (6).

What are alternative treatment options for GERD?

Amitriptyline can offer multiple advantages for GERD. However, there are a number of other treatment options available that are more commonly used for the treatment of GERD.

Pharmacotherapy

Pharmacological treatment includes:

Proton pump inhibitors (PPIs): These are the gold standard for the treatment of GERD. PPIs block the acid production in the stomach which helps with the symptoms like regurgitation, nausea and heartburn. They offer long-term relief (7). These medications include:

Omeprazole
Lansoprazole
Pantoprazole
Esomeprazole

H2 receptor antagonists: These medications also perform the same function as that of PPIs but through a different mechanism of action. H2 receptor antagonists are usually referred for milder symptoms and short-term action (8). These include:

Famotidine
Ranitidine
Cimetidine

There are some other medications that are helpful in treating the symptoms of GERD. These include:

Prokinetic agents such as metoclopramide
Sucralfate
Oesophagal barrier formers such as Gaviscon or alginates.

Lifestyle modifications

Lifestyle modifications are often the first line of defence against GERD (9).

Identify the trigger food. These help with avoiding the food that worsens the symptoms such as spicy food, fizzy drinks etc.
Obesity can prove to be concerning in the case of GERD.
Smoking can weaken the esophageal sphincter leading to esophageal reflux.
Practice relaxation techniques as stress can exacerbate GERD symptoms.
Remain in an upright position for 2-3 hours after eating. Do not lie down immediately after eating.
Keep your head elevated for 6-8 inches to avoid backflow of acid (10).

Natural remedies

Many natural remedies have been shown to be helpful with the symptoms of GERD.

Ginger has anti-inflammatory properties. This can help with the digestive system helping with nausea and vomiting associated with GERD.

Liquorice root coats and protects the oesophagal lining. This helps to reduce the irritation in the digestive tract.

Slippery elm protects the oesophagus providing relief to the stomach.

Probiotics help restore gut bacteria improving gut health which helps with the symptoms of GERD.

In my opinion, amitriptyline cannot treat GERD but it can help with the treatment. A few symptoms of GERD can be treated with the help of amitriptyline including regurgitation, heartburn and pain. Amitriptyline does not cure the condition but helps with the management of it.

If you experience any of the symptoms of GERD then consult your healthcare provider. They can help you with tailoring a treatment plan that suits your needs and helps you recover faster and better.

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References

1.-

Thour, A. (2023, July 18). Amitriptyline. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK537225/

2.-

Park SW, Lee H, Lee HJ, Park JC, Shin SK, Lee SK, Lee YC. et al. Low-dose amitriptyline combined with proton pump inhibitor for functional chest pain. World J Gastroenterol. 2013;19(30):4958–4965. doi: 10.3748/wjg.v19.i30.4958. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

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Radley DC, Finkelstein SN, Stafford RS. Off-label prescribing among office-based physicians. Arch Intern Med. 2006 May 08;166(9):1021-6. [PubMed] [Reference list]

4.-

Mohammad, S., Chandio, B., Soomro, A. A., Lakho, S., Ali, Z., Ali Soomro, Z., & Shaukat, F. (2019). Depression and Anxiety in Patients with Gastroesophageal Reflux Disorder With and Without Chest Pain. Cureus, 11(11), e6103. https://doi.org/10.7759/cureus.6103

5.-

Jansson, C., Nordenstedt, H., Wallander, M., Johansson, S., Johnsen, R., Hveem, K., & Lagergren, J. (2009, September 1). A Population-Based Study Showing an Association Between Gastroesophageal Reflux Disease and Sleep Problems. Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2009.03.007

6.-

Faruqui A. A. (2017). Gastroesophageal Reflux Disease Associated With Anxiety: Efficacy and Safety of Fixed Dose Combination of Amitriptyline and Pantoprazole. Gastroenterology research, 10(5), 301–304. https://doi.org/10.14740/gr898e

7.-

Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28; quiz 329. [PubMed] [Reference list]

8.-

Khan M, Santana J, Donnellan C, Preston C, Moayyedi P. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD003244. [PubMed] [Reference list]

9.-

Meining A, Classen M. The role of diet and lifestyle measures in the pathogenesis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2000;95:2692–2697. [PubMed] [Google Scholar]

10.-

Khan BA, Sodhi JS, Zargar SA, Javid G, Yattoo GN, Shah A, et al. Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux. J Gastroenterol Hepatol. 2012;27:1078–1082. [PubMed] [Google Scholar]

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Does amitriptyline help with GERD? (+3 treatment options)