Can Entyvio (natalizumab) cause Gastroesophageal Reflux Disease (GERD)?

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Entyvio Does Not Cause GERD

Entyvio (vedolizumab, not natalizumab) is not known to cause gastroesophageal reflux disease (GERD). There is no established causal relationship between Entyvio and the development of GERD in the medical literature or drug safety data.

Important Clarification

  • Entyvio is vedolizumab, a gut-selective integrin antagonist used for inflammatory bowel disease (ulcerative colitis and Crohn's disease), not natalizumab 1
  • GERD is a motility disorder resulting from reflux of gastric contents into the esophagus due to impaired esophageal clearance and anti-reflux barrier mechanisms 2, 3
  • The pathophysiology of GERD involves anatomical and functional factors including lower esophageal sphincter dysfunction, hiatal hernia, delayed gastric emptying, and esophageal dysmotility—none of which are mechanisms affected by Entyvio 4, 5

Why This Confusion May Arise

  • Patients with inflammatory bowel disease (the population taking Entyvio) may have concurrent GERD as a separate condition, not caused by the medication 3
  • GERD is extremely common in the general population with prevalence linked to Western lifestyle and obesity, making coincidental occurrence likely 4
  • Some gastrointestinal symptoms overlap between IBD and GERD, potentially leading to diagnostic confusion 6

If GERD Symptoms Develop While Taking Entyvio

  • Evaluate for GERD as an independent condition using typical diagnostic approaches including assessment of heartburn, regurgitation, and response to proton pump inhibitor therapy 1, 7
  • Consider upper endoscopy if alarm symptoms are present or if empiric PPI therapy fails 1
  • Do not attribute GERD symptoms to Entyvio without considering other more likely etiologies including dietary factors, obesity, and anatomical abnormalities 4, 3

Key Clinical Pitfall

The most common error is assuming that any gastrointestinal symptom in a patient on IBD therapy must be related to either the underlying disease or the medication, when GERD is a highly prevalent independent condition that requires its own diagnostic evaluation and management 1, 7.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Gastro-oesophageal reflux disease.

Nature reviews. Disease primers, 2021

Research

Gastroesophageal Reflux Disease.

Primary care, 2017

Guideline

Assessment for Gastroesophageal Reflux Disease (GERD)

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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