When stomach acid runs back into the lower esophagus, it causes a painful burning feeling known as acid reflux. Even though your heart remains unaffected, the burning sensation you may experience in your chest is generally referred to as heartburn. Acid reflux disease (also known as gastroesophageal reflux disease or GERD) is suspected when symptoms like these occur more than twice weekly.
Symptoms of GERD (gastroesophageal reflux disease)
Because it occurs at the gastroesophageal junction (where the esophagus meets the stomach), acid reflux disease is also known as GERD. Food travels down the esophagus, a tube connected at one end to the mouth and the other to the stomach. Normally, the lower esophageal sphincter (LES) controls the opening and closure of the junction, preventing acid from flowing backward into the lower esophagus when eating or drinking.
The lower esophageal sphincter (LES) is a ring of muscle that controls the opening and closing of the digestive tract. The sphincter relaxes to let food enter the stomach from the esophagus, then snaps shut once the stomach is full. Acid can reflux back into the lower esophagus if this sphincter, which acts as a “check” valve, malfunctions, opening too often or not shutting firmly enough.
The stomach is well-protected from the strong acid it secretes, yet stomach acid can injure the esophagus via reflux. Please click on the link at the bottom of the article to read more about stomach acid, the stomach environment, and the dangers of acid reflux.
Causes and Effects of Heartburn
Heartburn, regurgitation, bloating, bloody/black stools or bloody vomiting, burping, dysphagia, persistent hiccups, nausea, unexplained weight loss, wheezing, dry cough, hoarseness, or a chronic sore throat are all symptoms that may be caused by acid reflux.
Heartburn, also known as acid indigestion, is a burning pain or discomfort that originates in the stomach and can spread to other areas, including the abdomen, chest, and even the throat.
Causes and Symptoms of Acid Reflux
Regurgitation is the backing up of sour or bitter-tasting acid into the throat or mouth; this can come as a “wet burp” or even vomiting up some of the food contents you ingested earlier. * Regurgitation is worse when bending over or lying down; it is common after eating; the pain is worse when upright.
* Dysphagia, where food gets trapped in your throat due to an esophagus that is too thin.
The Roots of Heartburn
The root of the problem is intricate. Hiatal hernias are a common gastrointestinal defect found in patients with GERD. Patients with hiatal hernias do not necessarily suffer from acid reflux.
The diaphragm is a muscular partition that separates the abdominal cavity from the chest cavity. The esophagus enters the body through one of the three openings in this muscular wall, which leads to the upper stomach. Sliding hiatal hernias occur when the LES and upper portion of the stomach push up through this esophageal aperture into the lower portion of the esophagus while swallowing. Sliding hiatal hernias account for almost 90% of all cases.
Treatments Available Without a Prescription for Acid Reflux
Acid reflux can be treated with antacids, histamine-2 receptor antagonists, or proton pump inhibitors, all of which are available without a prescription.
Antacids
The acidity of the stomach can be neutralized with the help of antacid medications, which work by raising the stomach’s pH. Antacids derived from aluminum, bicarbonate, bismuth, calcium (carbonate or phosphate), citrate ion as citric acid or salt, glycine, magnesium, phosphate, potassium, sodium, silicates, tartaric acid, or its salts may be present in such products. While antacids may be effective on their own, it is not uncommon to find them in combination with other medications that target gas. The anti-gas components are also available in their own dedicated formulations.
Some of these well-known antacid brands may be familiar to you; if so, you can learn their active ingredient by reading the drug facts label, at which point you can shop around for a less expensive generic version.
Products:
– Tums
Tums contain calcium carbonate, an effective antacid component. The standard dose is 500mg, while the maximum is 750mg. Multiple dosages per day may be necessary because Tums operate quickly but also have a short half-life. This product also serves as a dietary calcium supplement, which is a nice bonus.
The Maalox
Maalox is a combination of antacid and antigas medication that relieves stomach acidity and flatulence. The active components in Maalox are an antacid and an antigas medication. Maalox’s antacid ingredients are aluminum hydroxide and magnesium hydroxide; the standard strength pill contains 200 mg of each, while the max strength product contains 400 mg of each. The antigas ingredient is simethicone, and the standard dose is 20 mg, while the maximum dose is 40 mg.
The Mylanta
Mylanta is a combination medication that helps with indigestion and gas. All of the Maalox formulations’ active components and dosages are the same.
Pepto-Bismol, for the Stomach Ache
Pepto-Bismol is a multipurpose medicine that stops diarrhea and calms an upset stomach. Pepto-Bismol’s standard strength is 262 mg, and the maximum strength is 525 mg; the active ingredient is bismuth subsalicylate.
Antihistamines That Target the H2 Receptor
Antibodies that target H-2 receptors prevent histamine from inhibiting cells in the stomach responsible for acid generation. The acid-lowering effects of medicines containing H-2 receptor antagonists can extend for as long as 12 hours.
Products:
Zantac, a brand name for ranitidine, is available over-the-counter (OTC) in 75 mg and 150 mg strengths.
Famotidine (Pepcid AC) is available over-the-counter (OTC) in two dosage strengths: 10 mg for regular use and 20 mg for maximum use.
Tagamet (cimetidine) is available in a 200 mg strength that is available without a prescription. Cimetidine can cause a variety of unwanted side effects, and male impotence is one among them.
You can find equivalent generics by searching for the active components ranitidine, famotidine, or cimetidine.
Inhibitors of Proton Pumps
By blocking the final step in the production of stomach acid, drugs containing proton pump inhibitors limit acid secretion in the stomach. These characteristics of proton pump inhibitors make them superior to h-2 receptor antagonists, as they can block acid production in the stomach for up to 24 hours.
Products:
The amount of omeprazole in Prilosec OTC is 20mg.
Zegerid (omeprazole and baking soda) over-the-counter dosage: 20 mg omeprazole and 1100 mg baking soda
Prevacid OTC 24 HR (lansoprazole) comes in two dosage strengths: 15 mg and 30 mg.
Modifying One’s Lifestyle to Reduce Acid Reflux Symptoms
Eat less, but more often
When you eat a lot, your stomach gets bigger and presses up against your lower esophageal sphincter, making it harder to swallow.
Acid-stimulating foods and drinks should be consumed in moderation.
Citrus fruits and vegetables, strawberries, and pineapples, as well as acidic beverages like coffee and tea, fall into this category.
Stay upright for at least two hours after eating. Don’t Eat Late-Night Snacks.
Standing or sitting up straight can help prevent stomach acid from leaking back into the digestive tract.
Keep your head a few inches above your bed’s surface.
If you need more support for your head while you sleep, you may always use more pillows. Nighttime heartburn sufferers can benefit from this technique because it lessens the force exerted by stomach contents pressing flat against the LES when the head is not lifted.
If you smoke, stop.
The LES is loosened by nicotine. When you already have acid reflux, smoking can make it much worse by increasing your stomach’s production of acid.
Do not drink alcohol or give up drinking.
Get some rest, or at least try to lessen the amount of stress in your life.
Although there isn’t enough proof to establish a direct correlation between stress and heartburn, it is known that stress can lead to actions that exacerbate the condition.
Do not cinch your waist with a belt or tight clothing.
As you can probably guess by now, people who suffer from acid reflux should avoid positions that put pressure on their stomachs from above. Constant pressure on the belly from tight clothing can cause the lower esophageal sphincter (LES) to relax and allow food to reflux back up into the esophagus.
A deeper dive into GERD
As a licensed pharmacist, one of my goals is to help individuals deal with the common ailments and symptoms associated with their health.
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