December 2017

Q: I’m not sure which type of over-the- counter antacid to choose for heartburn (or whether to choose another remedy). What are the differences?

A: Occasional heartburn is common. It’s caused by reflux of acidic stomach contents into the esophagus and is usually felt as a burning sensation behind the breastbone. Antacid preparations serve to neutralize gastric acid after it’s secreted. These have a continuing role in treating mild, occasional heartburn and supplementing prescription drugs in more severe disease. They are traditional, cheap, handy and relatively safe – although they are not without risks, and side effects can occur.

Most commercially available antacids combine aluminum and magnesium hydroxide. Some effervescent antacids contain sodium bicarbonate and aspirin. Some antacids are combined with an alginate (an insoluble substance that increases surface tension in liquid) to form a compound that floats on gastric fluids to protect the esophagus from acid exposure.

Antacid tablets are slow acting and have less neutralizing power than a liquid antacid. Tablets must be chewed and may not interact well with gastric acid. But for most, the convenience of tablets far outweighs these slight disadvantages.

Today, medications such as Zantac (an H2 blocker) and Prilosec (a proton-pump inhibitor) are used more commonly for frequent heartburn, although traditional antacids (Maalox or Gaviscon) still have a place for treating acute symptoms.

Source: International Foundation for Functional Gastrointestinal Disorders