Acid reflux can occur occasionally or it might be a chronic problem. Infrequent acid reflux that occurs from wrong diet or digestion problems is commonly treated with over-the-counter antacids. Although antacids provide quick relief from heartburn, they cannot cure chronic acid reflux or gastro-esophageal reflux disease (GERD) developing owing to a disorder of the sphincter muscles or esophagitis. To reduce heartburn triggered by excess acid secretion, acid suppressing drugs are usually prescribed to people suffering from chronic heartburn. Prokinetic drugs are occasionally recommended for treating this condition.
Drugs to Treat Acid Reflux
Antacids treat acid reflux by neutralizing the stomach acid. They provide short-term relief from heartburn. Sometimes these antacids are combined with other compounds to heal chronic heartburn or GERD.
Calcium carbonates, magnesium carbonate, aluminum hydroxide, magnesium hydroxide and magnesium trisilicate are different forms of antacids available in the form of chewable tablets or solutions.
Calcium carbonate is the main ingredient in most of the over-the-counter antacids. By neutralizing the acid content in the stomach, it provides fast relief from heartburn. Calcium carbonate antacids are usually effective in treating mild to moderate heartburn. Constipation is a common side effect of calcium carbonate antacids. Frequent intake of the antacid might trigger excess acid secretion, a condition commonly known as acid rebound.
Magnesium Based Antacids
Antacids containing different compounds of magnesium such as magnesium carbonate, magnesium hydroxide and magnesium trisilicate are recommended for acid reflux patients prone to constipation.
They are especially suitable for elderly people who might become constipated following calcium carbonate antacid intake. Diarrhea is a common side effect of these antacids. People with kidney problems should avoid antacids that contain magnesium.
Aluminum Based Antacids
Antacids containing aluminum are often recommended for treating occasional heartburn. However, they can cause constipation. Antacids containing aluminum should be used with caution by people suffering from chronic kidney problems. To prevent diarrhea or constipation and to maintain normal bowel movement, few antacid formulations combine aluminum compounds with magnesium compounds.
Antacids with Simeticone
Some of the drugs used for treating acid reflux contain antacids as well as simeticone. These medications are prescribed for treating heartburn triggered by flatulence.
Too much gas in the stomach tends to force the stomach juice into the esophagus, inducing acid reflux. Simeticone provides relief from gas by breaking down the gas bubbles.
Antacids with Alginates
Antacids are combined with alginates such as sodium alginate in some drugs used for treating GERD and indigestion. The antacid-alginate formulation forms a protective layer over the stomach contents that help to eliminate the ‘acid pockets’ from the stomach of GERD patients.
Acid Suppressing Drugs
Frequent heartburn is usually treated with acid suppressing drugs.
Acid suppressing medications are divided into two categories – proton pump inhibitors and histamine receptor blockers.
Histamine Receptor Blockers
Histamine receptor blockers, also known as H2 blockers or H2 receptor antagonists, suppress gastric acid secretion by impairing the activities of histamine 2 or H2, which triggers acid production in the stomach. H2 blockers widely used for treating acid reflux include ranitidine, cimetidine, famotidine and nizatidine.
These antacids work rapidly. By blocking the first stimuli to acid reflux, the benefits of the drug are realized within an hour after taking the medication. Headache, dizziness, constipation, diarrhea, fatigue and skin rash are rare side effects of H2 blockers.
Proton Pump Inhibitors
Proton pump inhibitors used for treating acid reflux include omeprazole, lansoprazole and esomeprazole. These are currently the most effective drugs for treating chronic acid reflux problems. In addition to reducing excess gastric acid secretion, proton pump inhibitors are prescribed for healing ulcers in the duodenum.
Proton pump inhibitors are considered safe. Compared with H2 blockers, they work for a longer time. However, overuse of this medication might make a person vulnerable to fracture, pneumonia, infections, vitamin B12 and iron deficiencies.
Prokinetic drugs such as cisapride, mosapride, domperidone, renzapride, itopride, prucalopride and metoclopramide are occasionally prescribed by physicians to reduce acid reflux. High lower esophageal sphincter pressure is frequently blamed for chronic acid reflux. By increasing the gastric emptying rate, prokinetic drugs help to reduce the esophageal sphincter pressure, thereby preventing the acidic content in the stomach from flowing into the esophagus.
Occasionally, prokinetic drugs are combined with H2 blockers to alleviate the symptoms of chronic acid reflux. The biochemical reaction of these drugs varies. Some of these prokinetic agents can cause serious side effects when used for a prolonged period. Cisapride is considered the safest prokinetic agent. The prokinetic drug metoclopramide causes drowsiness, restlessness and other neurological side effects.