Heartburn

Antacids medicines are over-the-counter (OTC) medication used to treat the symptoms of heartburn. They are usually available in tablet or liquid form and come in various different brand names. Antacids medicines include magnesium trisilicate, magnesium carbonate and aluminium hydroxide.

Some brands of antacid medicines may contain alginates, such as  alginic acid and sodium alginate, to help protect the lining of the gullet (oesophagus) from stomach acid. Alginates include: and are present in antacid medications with various different brand names. Also simeticone drug may be combined with antacids to help reduce wind (flatulence).

What is heartburn?

Despite the name, heartburn has nothing to do with the heart. Heartburn is caused when stomach acid passes out of the stomach and up into the oesophagus (the tube that carries food from the mouth to the stomach).

The acid can irritate the surface of the oesophagus, leading to the burning sensation associated with heartburn. Health professionals prefer to use the term gastro-oesophageal reflux disease, or GORD, to describe this condition because it’s a more accurate term than heartburn..

What conditions are antacids used to treat?

Your doctor would recommend antacid medicines to treat the symptoms of acid reflux which may cause heartburn or inflammation of the gullet (oesophagitis). Antacids may also be used to relieve some of the symptoms caused by ulcers in the stomach and duodenum (part of the gut) and to treat occasional bouts of indigestion (dyspepsia), where it is necessary to neutralise stomach acid.

However, there are new drugs in the market, called H2 blockers and proton pump inhibitors that are much more effective than antacids. While antacids only neutralise the acid for a short period, these new drugs work by reducing the amount of acid made by the stomach, which explains the preference of these new drugs. This is not to say that antacids not serve a useful purpose. Antacids are still used to provide quick relief of symptoms caused by stomach acid, especially in people who get intermittent bouts of mild indigestion (dyspepsia) or heartburn.

How do antacids work?

Antacids can work in two ways:

• they can coat the surface of the oesophagus to protect it from stomach acids, or
• they can produce a gel in your stomach, which helps prevent acid leaking up into your oesophagus.

Are antacids effective?

There is evidence that antacids are effective in providing short-term relief for the symptoms of GORD. However, long-term use is not recommended because there are more effective prescription medications for the treatment of recurring GORD, such as proton-pump inhibitors.

Lifestyle changes, particularly changes in diet, can reduce the symptoms of GORD. Your doctor will be able to provide more advice about diet.

You should see your doctor if the symptoms of GORD persist for more than a week, or they quickly return once the effects of the antacids wear off.

Who should not take antacids?

The long-term use of antacids in young children is not recommended. This is because they can interfere with the body’s ability to absorb calcium, which is required for the development of healthy bones.

There have been a number of cases where children have developed rickets (a developmental disorder) due to taking high-dose antacids over the course of five to six weeks.

Antacids are generally considered to be safe to take during pregnancy, but they can interfere with the absorption of iron. Therefore, if you need to take iron supplements during pregnancy, take them at least two hours before, or after, taking antacids.

Similarly, antacids may interfere with your body’s ability to absorb other types of medication, particularly if you take them at the same time. Your doctor or pharmacist can advise you about the best way to take both types of medication.

Some antacids contain high levels of magnesium and aluminium, which may be harmful for people who have a history of kidney disease. Also, some antacids contain high levels of salt, which may be harmful for those with high blood pressure (hypertension).

Ask your pharmacist or your doctor for advice about which antacids are suitable for you if you have high blood pressure or a history of kidney disease.

Side effects

A study that looked at how antacids affect people found that 12% of those who took antacids experienced side effects. The side effects included:

• diarrhoea,
• nausea,
• vomiting,
• blood in the stools,
• flatulence (wind), and
• constipation.

However, any side effects that you experience should pass once you stop taking antacids.

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