How Long Nexium Takes to Heal GERD, Ulcers, Gastritis, and LPR?

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What you need to know:

  • GERD: Nexium takes around 8 weeks on average to heal GERD-related esophagitis.
  • Uncomplicated H. pylori-induced ulcers: Nexium may take 2-4 weeks to heal small uncomplicated h. pylori-induced ulcers.
  • For complicated, h. pylori-indued ulcers (with bleeding or perforation), Nexium takes 12 weeks or more to heal such ulcers.
  • For NSAID-induced ulcers: Nexium takes 4-8 weeks to heal the ulcers.
  • Chronic gastritis and laryngopharyngeal reflux take up to 6 months to heal.

MORE: Why you Should Take Pantoprazole First Thing in the Morning: Gastroenterologist Explains.

The below table summarizes how long Nexium takes to heal different conditions:


Disease Average time Nexium (esomeprazole) takes to heal: (*)
1. GERD-related esophagitis. 6-8 weeks.
2. Barret’s esophagus. 6 months, or longer.
3. Peptic ulcers: h. pylori-related, uncomplicated, or small 2 weeks.
4. Peptic ulcers: h. pylori-related, complicated (bleeding or perforation), or large in size 4-12 weeks
5. NSAID-related ulcers. 4-8 weeks
6. Non-h. pylori, Non-NSAID ulcers. 4 weeks (uncomplicated).
8 weeks (complicated).
7. Chronic gastritis 2 weeks – up to 6 months or longer according to the severity
8. Laryngopharyngeal reflux (LPR). 6 months (controversial role).

(*) References to different periods are mentioned below in this article, each under its section.

1- GERD (Erosive esophagitis, Barret’s esophagus).

Nexium (Esomeprazole) takes about 8 weeks to heal GERD-related esophagitis. Studies show that up to 86% of GERD patients heal after the 8-week course of Nexium and other PPIs.

However, Your doctor may extend the duration of Nexium for up to 6 months or more. The aim is to maintain the healing of erosive esophagitis and prevent its recurrence.

If you remain symptom-free, your doctor will withdraw Nexium gradually.

 Barret’s esophagus VS erosive esophagitis.

  • Erosive esophagitis is the damage to the mucus membrane lining of the esophagus due to acid reflux (GERD).
  • Barret’s Esophagus: is abnormal healing of your esophageal mucus membrane after its damage. The healed mucus membrane becomes lined with a different cell type. Barret’s esophagus carries a high risk of malignant transformation to cancer esophagus (reference). 

In severe causes of Erosive esophagitis and barret’s esophagus, your doctor may prescribe Nexium for longer than 6 months. Nexium is effective in decreasing the risk of malignant transformation of the barret’s esophagus.

Interesting Insights from the research:

  • More than two-thirds of patients with non-erosive esophagitis have a recurrence of symptoms as heartburn (reference).
  • No significant differences in Nexium and other PPIs regarding the healing rates (reference).
  • Evidence supports the continuation of PPIs (as Nexium) indefinitely in the cases of severe reflux esophagitis and barret’s esophagus. Continued Nexium therapy may prevent cancer esophagus (reference).

However, Using Nexium long-term has some hazards and side effects. Don’t Use Nexium for extended periods without medical permission. 

2- Peptic ulcer disease.

A. H. Pylori-related ulcers:

  • Small uncomplicated ulcer, the standard 14-day course of Nexium 20 mg twice may be sufficient to heal the ulcer. However, your doctor may decide to continue Nexium if you have persistent or recurrent symptoms.
  • Eradication of H. pylori (with 7-14 days of antibiotics) is vital for Nexium to heal peptic ulcers. 
  • For large or complicated (bleeding) ulcers: your doctor will prescribe initial intravenous PPIs such as Nexium.
  • Then, a high dose of Nexium is given for 4 weeks to promote the healing of the ulcer. 
  • Nexium may require up to 12 weeks (3 months) to heal H. pylori-related ulcers (reference).

B. Analgesic or NSAID-induced ulcers.

Nexium takes about four to eight weeks of treatment to heal NSAID-induced ulcers. If you need to remain on NSAID (as aspirin), your doctor may prescribe low-dose PPI (as Nexium 20 mg) for extended periods. 

The 4-8 week course of Nexium is often sufficient to heal NSAID-induced ulcers. 

Non-h. pylori, Non-NSAID ulcers.

According to expert suggestion, for Nexium to heal such ulcers, it may take up to:

  • 4 weeks for uncomplicated duodenal ulcers.
  • 8 weeks for uncomplicated stomach ulcers.

Some ulcers (gastric and duodenal) are refractory to the standard 8-12 weeks treatment. Your doctor may prescribe Nexium for another additional 12 weeks. Also, He may prescribe Nexium twice a day, or add a bedtime H2 blocker (reference).

3- Chronic gastritis.

Chronic gastritis occurs due to a variety of causes. However, the most common are H. pylori-related gastritis and NSAID-induced gastritis.

The duration required for Nexium to heal gastritis varies according to the cause and the severity. 

Your doctor may prescribe Nexium (or other PPIs) for Two weeks up to 6 months or indefinitely according to the severity and the cause. 

Treatment of the cause (such as stopping analgesics and H. pylori treatment) is needed for Nexium to heal gastritis. 

Learn more about gastritis and gastropathy.

4- Laryngopharyngeal reflux (LPR).

LPR is the reflux of stomach contents (acid and digestive enzymes) into your throat (reference).

LPR usually accompanies GERD (acid reflux). No sufficient data in research regarding the duration needed for PPIs (as Nexium). 

A 6-month course of Nexium (or any other PPI) is recommended by the American Academy of Otolaryngology-Head and Neck Surgery. The 6-month period appears to be the average duration needed for Nexium to heal LPR.

Nexium may be less effective if LPR is not accompanied by GERD symptoms.

The AGA (Americal Gastroenterological Association) recommends AGAINST the use of PPIs (as Nexium) for isolated LPR without GERD (reference).

This diversity in recommendation reflects the lack of strong scientific evidence regarding the use of PPIs for LPR. Discuss the issue with your doctor.