Understanding How Antacids Work

Are you among the 15 million Americans who experience heartburn symptoms on a daily basis? Perhaps you count yourself among the 60 million people who endure the burning pain of acid indigestion at least once a month. Although more common among pregnant women and the elderly, anyone can find themselves racing to the medicine chest in search of over-the-counter (OTC) relief.

You’ve got several choices when it comes to non-prescription antacids, but not all acid reducers are created equal. As we review some of the most popular OTC medications used to quell heartburn, it’s important that you never use more than one antacid or acid reducer at a time without first consulting your gastroenterologist.

Types of antacids

Antacids are neutralizing, absorbing agents taken to relieve heartburn or indigestion caused by excess stomach acid. They typically contain salts of magnesium, aluminum, calcium and sodium. Antacids work by raising the gastric pH and are also used to provide symptomatic relief from peptic ulcers. Sodium bicarbonate antacids, including Alka-Seltzer and Bromo Seltzer, contain baking soda. Pregnant women, individuals with high blood pressure and those on salt-restricted diets should avoid this type of antacid.

Calcium carbonate antacids such as Tums and aluminum-based antacids like Amphojel may cause constipation. Some individuals experience diarrhea when using magnesium compounds such as Phillips’ Milk of Magnesia. For these reasons, many people prefer combination aluminum-magnesium antacids like Maalox and Mylanta that are less likely to cause constipation or diarrhea. Some of these formulas contain simethicone, an anti-foaming agent that helps reduce bloating by breaking down gas bubbles in your stomach.

Always take your antacid with food. This allows you up to three hours of relief. When ingested on an empty stomach, an antacid leaves your stomach too quickly and can only neutralize acid for 30 to 60 minutes.

It’s important to consult your doctor or pharmacist before you take an antacid if you’re on other medications to prevent interactions. Individuals with kidney or liver problems should never begin the use of antacids without speaking with their physician in order to avoid drug build-up.

Acid reducers

Acid reducers help to relieve heartburn by decreasing the amount of acid produced by the stomach.

OTC H2 blockers, such as Zantac and Pepcid, usually start to work within an hour and relieve symptoms for a longer period of time than antacids.

OTC proton pump inhibitors include Prilosec and Prevacid 24HR. These medications are recommended for people who have heartburn more than two days a week that don’t find relief in the other choices. Proton pump inhibitors are not as fast acting as antacids and H2 blockers, but the relief lasts longer.

Consult with your gastroenterologist before taking a proton pump inhibitor if:

You are elderly or have a compromised immune system. These medicines may increase your risk for pneumonia.
You are a postmenopausal woman. Proton pump inhibitors reduce calcium absorption and may increase your risk for osteoporosis.
You have been treated for a Clostridium difficile infection. Proton pump inhibitors may put you at an increased risk for a return of the infection.

Short-term fix, not a long-term solution

Antacids are great for providing fast, short-term relief, but they don’t correct the underlying problem causing your symptoms. If after two weeks of self-treatment with OTC medicines you still suffer from heartburn and excess stomach acid—it’s time to see your doctor. Frequent and persistent symptoms can indicate a more serious problem such as gastroesophageal reflux, or GERD, advises the American College of Gastroenterology:

“When GERD is not treated, serious complications can occur, such as severe chest pain that can mimic a heart attack, esophageal stricture (a narrowing or obstruction of the esophagus), bleeding, or a pre-malignant change in the lining of the esophagus called Barrett’s esophagus.”

Studies show that patients with chronic, longstanding, untreated heartburn are at substantially greater risk for esophageal cancer – a rapidly growing and highly fatal cancer in the United States.

Don’t ignore persistent symptoms of heartburn or reflux. It’s fine to try an OTC solution for a week or two, but if discomfort persists, book an appointment with your gastroenterologist. Seeing your doctor early helps you get immediate treatment to avoid far more serious problems down the line.
Do you or a loved one struggle with frequent bouts of heartburn? Revere Health’s gastroenterologists diagnose and treat a wide variety of disorders of the gastrointestinal tract, including acid reflux, ulcers and Barrett’s esophagus. We offer compassionate, patient-centered care in multiple Utah locations and work with you to develop a treatment plan based on your individual needs and goals.