Antacids
You experience heartburn and acid regurgitation more often than most people when you have gastroesophageal reflux disease (GERD). Your doctor may recommend trying over-the-counter (OTC) antacids in conjunction with diet and lifestyle changes to treat these symptoms.

Your doctor may prefer that you first try only lifestyle changes such as modifying the type of food you eat, the amount you eat, and when you eat it before introducing antacids or other medications. However, many patients with mild symptoms sometimes require occasional drug therapy. Mild GERD symptoms are often treated with antacids—the drugs of choice for quick relief of GERD-related symptoms.

How Do Antacids Work?

Many of the same drugs that are used to treat gastritis and peptic ulcers can also be effective for treating mild GERD symptoms. According to The Merck Manual, antacids can usually relieve the pain of esophageal ulcers caused by GERD by neutralizing and reducing the amount of acid that your stomach produces.

Most OTC antacids are able to weaken your stomach acid because they contain various combinations of three basic salts—magnesium, calcium, and aluminum—along with hydroxide or bicarbonate ions. These help neutralize the acidity in your stomach. Antacids can often provide fast short-term relief for heartburn and reflux discomfort by reducing the effects of acid.

Antacids are taken in varying doses depending on their strength. Typically one dose of an antacid often relieves heartburn for about an hour and their effects are not as long-lasting as other medicines for GERD. For maximum effect, you should take antacids immediately after eating if symptoms occur, according to the AAFP.

Are There Different Types of  Antacids?

Antacids can be taken as a liquid, a chewable tablet, gum, or in pill form as a dissolving tablet. Each of these forms is available without a prescription. Liquid antacids may relieve symptoms faster than other forms. Many OTC medicines combine different antacids. Some common brands include:

  • Tums
  • Maalox
  • Mylanta
  • Alka-Seltzer
  • Pepto-Bismol
  • Rolaids
  • Riopan
  • Gaviscon
  • Gelusil
  • Titralac
  • Alka-2

There are different types of antacids that cause different actions, for example:

  • Antacids that contain alginic acid, such as Gaviscon, contain a foaming agent that floats on top of your stomach contents. This may help keep your stomach juices from coming in contact with your esophagus.
  • Antacids that contain simethicone, such as certain formulations of Maalox or Mylanta, may break down gas bubbles in your stomach, which can help keep acid from entering your esophagus.
  • Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can provide a supplemental source of calcium.

What Are the Risks of Using Antacids?

Although antacids can be effective at relieving GERD symptoms, overuse of this treatment can lead to side effects. Fortunately, these side effects are usually minor and resolve on their own without the need for additional treatment. Side effects may include:

  • diarrhea
  • constipation
  • nausea
  • headaches

Certain salts that are used in many antacids are often responsible for these side effects. Magnesium salt can lead to diarrhea and aluminum salt may cause constipation. To help balance these side effects, aluminum and magnesium salts are often combined in a single antacid preparation. Calcium carbonate can also cause constipation in some people and lead to a side effect called “acid rebound.” In acid rebound, the stomach produces even more acid, worsening heartburn instead of improving it.

Antacids can interact with a number of drugs, including tetracycline and ferrous sulfate, which can cause potential adverse events. To avoid possible interactions with other medicines that you take, talk to your doctor before using antacids. Use only one type of antacid at a time, unless your doctor instructs you otherwise.

Avoid using antacids that contain calcium carbonate or aluminum hydroxide and magnesium carbonate if you have kidney disease. Don’t use antacids for longer than two weeks, unless you have talked to your doctor about continuing to take them.

While OTC antacids can help relieve mild GERD symptoms for many people, they may not work for everyone—particularly those with more frequent or severe symptoms or complications. The use of antacids alone isn’t enough to heal damage to the esophagus caused by stomach acid.

Your doctor may recommend escalating your treatment to include prescription medications or, in severe cases, surgery if your symptoms don’t improve within a few weeks. Your doctor can help guide you to the right treatments for your particular condition.