--Acid neutralizers, such as Tums, Rolaids, Alka-Seltzer, Maalox and milk of magnesia. These medications work by neutralizing the acid already produced in the stomach and are largely available over the counter. They can be effective for occasional symptomatic reflux. If you have other medical conditions--especially kidney disease--use caution with over-the-counter preparations containing calcium magnesium or phosphate. It's also important to know that Alka-Seltzer contains aspirin. For acid reflux, use the Alka-Seltzer Heartburn preparation, which does not contain aspirin.
--H2 blockers, or histamine blockers, such as Pepcid, Zantac, Tagamet and Axid. These medications work by blocking much of the acid produced in the stomach. They are available in both over-the-counter and prescription strength. H2 blockers are more effective for frequent heartburn treatment and for healing injury to the esophagus than the acid-neutralizing medications.
Prilosec, Nexium, Aciphex, Protonix, Zegerid, Prevacid and Kapidex. They block the final common pathway of acid production in the stomach and are the most effective for the healing and maintenance of symptoms. Prilosec has an over-the-counter option but it's not time-released and therefore not as effective as the prescription strength. Most of these medications should NOT be taken with Plavix, an antiplatelet agent for the prevention of heart attack or stroke. PPIs may interfere with the effect of Plavix. If you take Plavix and are on a reflux medicine, check with your doctor or pharmacist to be sure it's safe.
If you want to avoid taking prescription medication for acid reflux--or if you've tried it and your reflux is still a problem--you might consider the following treatments:
1. Surgery can tighten the junction of the stomach and the esophagus.
2. Lifestyle modification, primarily weight loss, can have dramatic results. But even if you don't have a lot of weight to lose, eating smaller meals and going to sleep with an empty stomach can help.
3. Elevating the head of the bed a few inches with wooden blocks can make a difference. Let gravity help you.
I hope you now have a good idea of what acid reflux is, how it develops and the possible treatment and lifestyle options that can help alleviate its uncomfortable symptoms. This information may help prevent potential complications that can result from untreated, long-term exposure of the esophagus to acid. If you have frequent symptoms--especially a red-flag symptom--it might be worthwhile to see a castroenterologist near you.
(Dr. Steven A. Porter is recognized as one of the nation's leading gastroenterologists, specializing in colonoscopy, upper endoscopy, pancreatic and biliary issues. He and his physician assistant, Phil Merrill, provide many other GI services, including treatment for reflux, irritable bowel, Crohn's, colitis and liver and bile duct disorders. Dr. Porter practices in Ogden, Utah.)
(WhatDoctorsKnow is a magazine devoted to up-to-the minute information on health issues from physicians, major hospitals and clinics, universities and health care agencies across the U.S. Online at http://www.whatdoctorsknow.com.)