Antacids for reflux
About 10% of the population regularly encounters dysphagia (weekly or daily). Antacids are prescribed for immediate relief of symptoms in case of occasional acid reflux or as symptomatic therapy when added to H2-receptor antagonist or proton pump inhibitor therapy. However, acid inhibitory therapy with antacids is also effective in healing reflux-oesophagitis and this step should not be missed as a part of the step-wise plan.
Antacids are best dosed either as needed, or 1 and 3 hours after eating and before bed. However, because antacids can interfere with other medications, it is wise to space the dosing of the medications 1 to 2 hours from the administration of an antacid.
Antacids containing aluminium (algeldrate) and/or calcium (calcium carbonate) tend to have constipating properties, whereas those with magnesium (magnesium oxide) tend to cause diarrhoea. For this reason, the most commonly used products contain both aluminium and magnesium. Due to the absorption of sodium-containing antacids, these drugs should be used with caution in patients with heart failure.
Extra info: Antacids containing magnesium act locally in the stomach and are hardly absorbed. Through their acid-neutralizing activity, they stimulate pepsinogen activation and gastrin levels. Magnesium stays in the GI tract, thereby drawing water into the GI lumen and increasing intestinal motility, which can cause diarrhoea.
What is the most common adverse effect of aluminium-containing antacids?
Extra info: Antacids containing aluminium are known to cause constipation (in contrast to the magnesium-based antacids, which promote diarrhoea).