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The cost of GERD and acid reflux in the workplace

What you (and your employees) need to know.

*This article was last updated February 2022.

Many Americans don't know what heartburn is or that they have it. Heartburn is a symptom of both acid reflux External Site and gastroesophageal reflux disease (GERD). It's estimated to affect 60 million Americans External Site at least once a month, and one in five Americans suffer from heartburn and acid reflux at least once per week, according to WebMD®.

With numbers this high, there's a good chance heartburn affects at least one of your employees. Here's what you and your employees need to know.

What's the difference between heartburn, acid reflux, GERD and peptic ulcer disease?

Though many often confuse these terms, there are some key differences.


  • Happens in the esophagus — not the heart
  • Causes mild to severe chest pain
  • Can be mistaken for a heart attack
  • Symptoms of acid reflux

Acid reflux

  • Caused by a weak lower esophageal sphincter
  • Happens when stomach acid flows back up the esophagus


  • Chronic from acid reflux
  • Diagnosed when acid reflux happens 2x a week
  • Can cause inflammation in the esophagus

Peptic Ulcer Disease

  • Caused by an overproduction of stomach acid
  • Leads to open sores in stomach lining or small intestine

If your employees have any of the above conditions and don't address their symptoms, they'll likely see an increase in health problems — and the costs associated with them — down the road. Untreated GERD can lead to esophageal bleeding or ulcers, esophageal cancer, asthma or other upper respiratory issues, and even dental problems (acid reflux can wear down tooth enamel, affect saliva production, and cause bad breath).

What are these conditions costing my employees and my business?

All of these conditions can impact your business if your employees have them. According to the International Foundation for Gastrointestinal Disorders External Site, GERD can be significantly expensive due to how it needs to be continuously managed for long periods of time.

Direct costs include over-the-counter and prescription medications, trips to the doctor or hospital, and even costs of surgery and other complications like esophageal cancer. However, the indirect costs of untreated heartburn, acid reflux, GERD, and peptic ulcer disease are even more critical. Not only do these conditions significantly affect your employees' quality of life, they also cost U.S. businesses in lost productivity — nearly $2 billion each week, according to a report from the American College of Gastroenterology External Site.

Wasn't there a recent drug recall for heartburn medications?

In September 2019, the Food and Drug Administration External Site reported that it detected small amounts of N-Nitrosodimethylamine (NDMA) in several brand-name and generic heartburn medications. Low and harmless levels of NDMA are also found in water, meat, dairy and vegetables, but high amounts of exposure are thought to cause gastric or colorectal cancer External Site

Findings from the FDA revealed that the traces of NDMA in these medications increase over time when stored at higher than room temperatures, which could result in unacceptable levels of human exposure. As a result of these findings, the FDA has ordered all ranitidine medications, sold under the brand name Zantac®, be removed from store shelves immediately. However, the manufacturer has reformulated their product with famotidine — called Zantac 360 External Link — which the FDA has deemed as a safe alternative to the old ranitidine formula.

At this time, FDA testing has not found NDMA in other commonly used medications used for heartburn, acid reflux, GERD, and peptic ulcer disease, including famotidine (Pepcid), cimetidine (Tagamet®), esomeprazole (Nexium®), lansoprazole (Prevacid®) or omeprazole (Prilosec®).

What do my employees need to know?

Encourage your employees to talk to their doctor about treatment options available for heartburn, acid reflux, GERD, and peptic ulcer disease. You can also share tips to reduce the chances of experiencing heartburn, which include lifestyle changes like:

  • Maintaining a healthy weight
  • Avoiding common trigger foods and beverages External Site External Site, like alcohol, garlic, onions, spicy foods, chocolate, citrus fruits, coffee, tea, soda, peppermint and tomatoes
  • Wearing loose-fitting clothing
  • Allowing two hours after a meal before lying down, and avoiding late-night meals or snacks
  • Limiting the use of certain OTC medications, such as NSAIDs, which can damage the protective layer within the stomach with prolonged use

Questions? Contact your authorized Wellmark Blue Cross and Blue Shield account representative, or email us at Send Email.