Antacids – why taking them very frequently is not good for you!

Here is the mechanism of action, indications, side-effects and adverse effects of antacids.

Shraddha Rupavate | Updated: February 24, 2015 5:15 pm

If you’re among those thousands of Indians who frequently suffer from heartburn and indigestion after enjoying a spicy meal, then you most likely must’ve sought relief by popping over-the-counter antacids.

But are you sure that antacids will resolve your digestive problems without having an additional effect on your body? In this article, we provide a brief overview of antacids with inputs from Dr (Col.) M. Bhagat, Senior Consultant, Gastroenterology, Delhi based Sri Balaji Action Medical Institute.

What are antacids? What do antacids do?

The stomach digests the food you eat with the help of hydrochloric acid that it naturally secretes. When acid in the stomach is insufficient or in excess, the stomach wall may get damaged giving rise to various gastrointestinal symptoms such as stomach pain and heartburn. (Read: 10 home remedies for acidity that really work!)

Antacids, as the name suggests, work against excess acid. They neutralize acid and reduce acid reflux into the esophagus. They are a class of drugs used to treat conditions caused by acid production in the stomach. (Read: Beat acid reflux, GERD with Endostim – the new minimally invasive technique)

Antacids can be of two types:

Chemical antacids: They chemically neutralize gastric acid. They act rapidly but may cause acid to rebound once the drug concentration reduces. Some chemical antacids may contain high sodium concentration which may not be suitable for hypertensive patients.
Absorbable antacids: These antacids contain calcium and magnesium salts which adsorb excess acid on their surfaces. They rarely cause acid to rebound but cause drug interactions.

Commonly available over-the-counter antacids include aluminum hydroxide gel/suspension, calcium carbonate, magnesium oxide and sodium bicarbonate.

When should antacids be taken?

Dr (Col.) M. Bhagat says ‘Antacids should be taken in situations of hyperacidity, burning pain, peptic ulcers, esophageal acid reflux and with non-steroidal anti-inflammatory drug (NSAIDs). They can also be helpful to treat patients having minor indigestion with sour eructations and patients with chronic kidney diseases.’

Antacids are fast acting drugs and their effect lasts up to 3 hours after intake. They should always be taken after having meals (at least one hour later) because they are capable of reducing acid in the stomach within 20-40 minutes of intake. It is also recommended that antacids should be taken at least one hour before or after taking any other medication to avoid drug interaction.

Can frequent use of antacids mask other intestinal problems?

Dr (Col.) M. Bhagat says ‘Yes, frequent and prolonged use of antacids potentially mask other intestinal problems like ulcer symptoms and may also lead to perforations of existing ulcers.’

What are the side-effects of antacids?

Dr (Col.) M. Bhagat says ‘Antacids cause inhibition of acids which in turn can impair the digestion process. It also inhibits calcium absorption.’

Common side-effects of antacids include diarrhea, bloating and poor digestion. Other rare side-effects that have been noted depend on the active substance present in the antacid used. (Read: Acidity: A cause for heartburn)

Antacids containing aluminum hydroxide may cause constipation, aluminum-intoxication, osteomalacia (softening of the bones), and hypophosphatemia, low levels of phosphate in the blood.
Antacids containing sodium bicarbonate cause nausea and vomiting, breathing problems, headaches, nervousness, muscles pain and weakness. It may be associated with frequent urge of urination.
Antacids containing magnesium salts cause diarrhea. In patients with kidney problems, they can increase blood levels of magnesium.
Antacids containing calcium may cause hypercalcemia (milk alkali syndrome) and can increase calcium output in the urine. It may cause constipation, nausea, vomiting, muscle weakness and loss of appetite.

Long term use of antacids can be harmful. It can lead to chronic acid reflux and severe indigestion problems. If you suffer from any of the above side effects due to antacids, stop taking the medicine at once and visit a doctor. (Read: 10 reasons for bloating or abdominal gas you didn’t know about)

Drugs that you should avoid taking with antacids

Adsorbable antacids interact with several drugs including antibiotics, asthma drugs, tuberculosis drugs, blood pressure drugs, diabetes drugs, amphetamines and anti-inflammatory drugs. They decrease the efficacy of these drugs by adsorbing them.
Antacids interact with drugs such as pseudoephedrine to cause drug toxicity (increased levels of drugs in the blood).
Antacids containing sodium bicarbonate interferes with the excretion of several other drugs such as quinidine and amphetamines. These antacids also increase excretion of aspirin by the kidneys.

Consult a doctor before taking an antacid if you suffer from hypertension, congestive heart failure (CHF) or kidney disease.

Read more about causes, symptoms, diagnosis and treatment of acidity.

References:

Suvarna Bhoir, AM Bhagwat. Comparison of Seven Oxethazaine Containing Antacids Available in the Indian Market.

Treating Heartburn With Over-the-Counter Drugs (http://www.webmd.com)

Heart Burn (http://www.mayoclinic.org)

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Published: January 14, 2014 6:46 pm | Updated:February 24, 2015 5:15 pm

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