Antacids are over-the-counter medications that alleviate discomfort from excess stomach acid. Their primary role is to provide quick relief for occasional heartburn, indigestion, and upset stomach. These symptoms often stem from acid reflux, where stomach acid flows back into the esophagus, causing a burning sensation in the chest. Antacids offer a solution for managing these common digestive issues, providing comfort from mild, infrequent acid-related distress.
Types of Antacids
Common antacids contain various active ingredients, each with distinct properties and potential side effects. Calcium carbonate, found in products like Tums and Rolaids, is a widely used antacid that quickly neutralizes stomach acid. It can lead to side effects such as constipation, burping, and gas. Prolonged or excessive use of calcium carbonate may also contribute to high calcium levels in the blood, known as hypercalcemia, and kidney stones.
Aluminum hydroxide, present in medications such as Amphojel and Maalox, also works by neutralizing stomach acid. A common side effect is constipation, which can lead to fecal impaction. Long-term use or high doses, especially in individuals with impaired kidney function, can result in aluminum toxicity and low phosphate levels in the blood, affecting bone health.
Magnesium hydroxide, often found in Milk of Magnesia and also in Maalox, is another effective antacid that acts rapidly. Its primary side effect is diarrhea, often combined with aluminum hydroxide to balance bowel effects. Overuse can lead to electrolyte imbalances, and in individuals with kidney problems, elevated magnesium levels in the blood may occur.
Sodium bicarbonate, a component of effervescent tablets like Alka-Seltzer, provides very fast relief due to its quick reaction with stomach acid. This rapid neutralization can produce carbon dioxide gas, leading to bloating, burping, and gas. Individuals with high blood pressure, heart failure, or kidney disease should use sodium bicarbonate with caution due to its sodium content, which can exacerbate these conditions.
How Antacids Provide Relief
Antacids work by chemically neutralizing excess hydrochloric acid in the stomach. Their active ingredients are alkaline compounds, or bases, which react with acidic stomach contents. This reaction involves the antacid’s alkaline ions binding to hydrogen ions in stomach acid, forming water, a salt, and sometimes carbon dioxide gas.
This neutralization increases the stomach’s pH, making the environment less acidic. This reduces the corrosive effect of stomach acid on the stomach lining and esophagus, alleviating the burning sensation of heartburn and indigestion. Reduced acidity also decreases the activity of pepsin, a digestive enzyme activated in highly acidic conditions that can irritate the esophagus during reflux.
Using Antacids Safely
Antacids are used for occasional, mild symptoms of heartburn and indigestion. They offer quick relief, within a few hours, but do not address the underlying cause of the symptoms. It is recommended to take antacids about an hour after eating or when symptoms arise. For nighttime symptoms, do not consume with food.
While safe for short-term use, antacids can interact with other medications, affecting their absorption or effectiveness. They can reduce the absorption of certain antibiotics, such as tetracyclines and fluoroquinolones, and iron supplements. Separate antacids and other medications by at least 2 to 4 hours to minimize potential interactions.
Overdosing or prolonged use can lead to various side effects depending on the active ingredient. Excessive use of calcium carbonate can cause constipation and high calcium levels, while magnesium-containing antacids may lead to diarrhea. Sodium bicarbonate can contribute to increased blood pressure and fluid retention, especially with pre-existing heart or kidney conditions.
Consult a healthcare professional if symptoms are frequent, severe, worsen, or do not improve with antacid use after two weeks. Other concerning symptoms include difficulty swallowing, unexplained weight loss, nausea, vomiting (especially with blood or black material), chronic cough, or chest pain with discomfort in the neck, jaw, or arms. These symptoms could indicate a more serious underlying condition beyond over-the-counter antacids.