GERD and anemia: How are they connected? 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Anemia occurs when there are not enough red blood cells (RBCs) in the body. GERD itself and certain GERD medications may both cause anemia. For this reason, treating GERD-related anemia involves different approaches, depending on the exact cause. This article discusses GERD and anemia and explores the connection between them. It also outlines treatment options for GERD-related anemia, and some possible preventive measures. What is GERD Share on PinterestTom Werner/Getty ImagesGERD is a condition that affects the digestive system. It causes a person’s stomach contents, such as stomach acid and food, to move upward into the esophagus. People with GERD often experience heartburn due to stomach acid damaging the inside of the esophagus. Less common symptoms of GERD include:dental erosionchest paindysphagialaryngitischronic coughasthma GERD is common in the United States, affecting 18.1–27.8% of adults. Scientists remain unsure about its exact causes. There are several risk factors for GERD. The condition is more likely to occur in people:with obesitywho are 50 years of age or olderwho smoke tobaccowho drink alcohol Individuals are also at a greater risk of developing GERD if they regularly take certain medications, such as:nonsteroidal anti-inflammatory drugsantidepressantsaspirin What is anemia Anemia affects RBCs within a person’s body. Scientists define anemia as a condition in which the number of RBCs circulating in the body decreases. There are two main types of anemia: hyperproliferative anemia and hypoproliferative anemia. Hyperproliferative anemia occurs when certain bodily processes destroy RBCs prematurely. By contrast, hypoproliferative anemia develops when the bone marrow does not produce sufficient amounts of RBCs. Some people with mild anemia do not experience any symptoms. In others, however, the condition can cause significant health issues. Symptoms of anemia include:weaknesstirednesslethargyrestlessnessa reduced ability to exerciseshortness of breathchest pain Approximately 25% of people globally have anemia. A person may develop the condition for a number of reasons. For instance, around 50% of all anemia cases are due to iron deficiency. Other causes of anemia include:sickle cell diseasesome communicable diseasesissues with the immune systemblood loss from surgery, hemorrhage, or menstruation Connection between GERD and anemia Although GERD and anemia are very different conditions, there are some important connections between them. Research shows that GERD can sometimes cause esophagitis, which is inflammation of the esophagus. Some people with esophagitis may then develop gastrointestinal bleeding. This loss of blood may cause anemia and other conditions. There is also evidence that long-term use of GERD medications called proton pump inhibitors (PPIs) may lead to iron deficiency anemia. Several case studies support this finding. Treatment Treating anemia involves addressing its underlying cause. For example, doctors may treat iron deficiency anemia with oral iron supplements while working on the underlying cause of the condition. The same principle applies to GERD-related anemia, whether it is due to internal bleeding from esophagitis or iron deficiency from using PPIs. In the latter case, doctors may advise a person to stop using this GERD medication. In general, there are three main approaches to treat GERD:making some lifestyle changes, such as practicing good sleep hygiene and reaching or maintaining a moderate body weighttaking medications such as PPIsundergoing surgery Prevention To prevent GERD, it is best to avoid the associated risk factors. This could mean:quitting smoking, if applicableavoiding consuming alcohol, if applicablereaching or maintaining a moderate body weight Although these measures cannot completely eliminate the likelihood of developing GERD, they can lower a person’s risk. Some people believe that eliminating certain foods may prevent the onset of GERD symptoms. These include:spicy foodscitrus fruitscaffeinechocolate However, scientists are still debating whether this is helpful for managing the condition. Frequently asked questions Below, we answer some of the most common questions about GERD and anemia. Can GERD cause low blood count Yes, GERD may cause a low RBC count, or anemia. Is acid reflux a symptom of iron deficiency No. Acid reflux is a symptom of GERD, which may cause iron deficiency anemia. Can low stomach acid cause low iron levels Yes. Having too little stomach acid can disrupt digestion, making it harder for the body to extract iron from food. Can low iron levels cause digestive issues No. Doctors do not consider digestive issues to be a symptom of iron deficiency or iron deficiency anemia. Summary GERD is a common condition that may cause anemia. Moreover, some GERD treatments may also lead to this condition. For this reason, a medical diagnosis is essential to receive appropriate treatment. People may be able to prevent developing GERD and anemia by making certain lifestyle changes, such as quitting smoking or avoiding consuming alcohol. A person should seek guidance from a doctor if they are experiencing symptoms of GERD or anemia. Last medically reviewed on May 23, 2022Acid Reflux / GERDBlood / Hematology 7 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Antunes, C., et al. (2022). Gastroesophageal reflux disease.https://www.ncbi.nlm.nih.gov/books/NBK441938/Clarrett, D. M., et al. (2018). Gastroesophageal reflux disease (GERD).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/Fatima, R., et al. (2022). Achlorhydria.https://www.ncbi.nlm.nih.gov/books/NBK507793/Imai, R., et al. (2018). Iron deficiency anemia due to the long-term use of a proton pump inhibitor.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891535/Kobets, A., et al. (2021). An unusual presentation of iron-deficiency anemia: An autobiographical case report.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760012/Turner, J., et al. (2022). Anemia.https://www.ncbi.nlm.nih.gov/books/NBK499994/Warner, M. J., et al. (2021). Iron deficiency anemia.https://www.ncbi.nlm.nih.gov/books/NBK448065/FEEDBACK:Medically reviewed by Alana Biggers, M.D., MPH — By Mathieu Rees on May 23, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageGERD (persistent acid reflux): Symptoms, treatments, and causesMedically reviewed by Saurabh Sethi, M.D., MPH Gastroesophageal reflux disease (GERD) is long-term, regular acid reflux. This can cause heartburn and tissue damage. Medication and surgery can treat…READ MOREWhat to know about anemiaMedically reviewed by Meredith Goodwin, MD, FAAFP Anemia is the most common blood disorder. 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