What is the Safest Acid Reflux Medication?

Acid reflux and gastroesophageal reflux disease (GERD) medications aim to reduce stomach acid in an effort to ease reflux symptoms. There are three primary heartburn medications accessible, both as OTC medication and prescription medication: antacids, H2 blockers, and proton pump inhibitors. This article will provide insights into the root causes of acid reflux symptoms and GERD symptoms, as well as the pros and cons of each acid reflux medication.

GERD vs Acid Reflux

Acid reflux, often referred to as gastroesophageal reflux or heartburn, occurs when the acids in your stomach move back into the esophagus. Gastroesophageal reflux disease (GERD) is a more persistent and severe type of acid reflux. If left untreated, these conditions can damage the esophagus or even cause esophageal cancer.

Frequent heartburn is widespread, with millions of Americans experiencing heartburn symptoms at least once monthly. Furthermore, a significant 15 million Americans face heartburn symptoms daily.

Reflux disease, or GERD, is also prevalent. Approximately one out of every five Americans struggle with gastroesophageal reflux disease, as reported by the International Foundation for Gastrointestinal Disorders.

A significant segment of the United States has encountered these symptoms at some point in their life, and a number people will rely on medications for heartburn relief.  

The good news is that GERD and acid reflux are largely manageable. Based on the severity of the symptoms, healthcare providers will determine the most appropriate acid reflux medication and treatment strategy for patients. They might also suggest lifestyle modifications, such as dietary changes and physical activity, to alleviate symptoms.

To choose the safest acid reflux medication, it’s crucial to understand the underlying causes of acid reflux and gastroesophageal reflux disease.

Fact: Approximately 15 million Americans deal with heartburn daily.

What is Acid Reflux? 

Acid reflux occurs when stomach acid flows back into the esophagus. It’s a common issue that affects many people.

The primary symptom of acid reflux is heartburn. In fact, the terms are often used interchangeably. Heartburn manifests as a burning sensation behind the breast, and can extend to the throat or neck, sometimes resulting in a bitter or sour taste in the mouth. Heartburn symptoms can persist for several hours, and often intensify after eating.

Experiencing acid reflux symptoms more than twice a week might indicate a more severe condition known as gastroesophageal reflux disease.

Acid Reflux Triggers

Diet adjustments can help some people manage their reflux symptoms, reducing their reliance on acid reflux medication.

Specific foods can exacerbate heartburn. It’s advisable to steer clear of these triggers. Foods rich in spices, salt, and fat linger in the stomach for extended periods of time, increasing the chance of acid reflux.

Potential acid reflux triggers include:

• High-fat meats, like bacon and sausage
• Carbonated drinks
• Chocolate
• Dairy products, like cheese
• Spices
• Common fast food items
• Greasy dishes
• Citrus fruits, like oranges, lemons, and limes
• Various peppers, including white, black, and cayenne
• Peppermint flavors
• Pizza
• Packaged treats, like chips
• Tomato sauces

Adjusting your diet is oftentimes the first step in addressing reflux and heartburn. Too often, people rely on medication without paying attention to the foods they eat.  

Foods to Reduce Acid Reflux 

Modifying your diet slightly can effectively manage symptoms of acid reflux. Healthcare providers often advise patients to consume smaller, more frequent meals and avoid eating large meals and snacks before bed.

Foods that can help alleviate heartburn include:

• Whole grains, like oatmeal and brown rice
• Root vegetables, such as sweet potatoes and carrots
• Green, leafy vegetables
• Fruits with low acidity, like cauliflower, bananas, melons, and nuts 
• Hydrating foods, including watermelon, herbal teas, cucumber, lettuce, and celery 

Incorporating foods rich in fiber with alkaline ingredients high water content can mitigate heartburn. Increasing your intake of these nutrients can regulate gastric acid production.

What is Gastroesophageal Reflux Disease? 

Gastroesophageal reflux disease (GERD) is a more persistent and severe form of acid reflux. If you experience severe heartburn symptoms more than twice a week, it could be an indication of GERD.

Some medications, including certain asthma medications, calcium channel blockers used for high blood pressure, nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, and benzodiazepines can trigger or exacerbate GERD symptoms 

In patients with GERD, the sphincter in the lower esophagus relaxes too often, allowing digestive enzymes, gastric acid, and other stomach contents to sit in the esophagus.

People with abdominal hernias, pregnant women, smokers, or those who are overweight face an increased risk of developing gastroesophageal reflux disease.

Symptoms of GERD

People with gastroesophageal reflux disease exhibit similar symptoms to those who have acid reflux. However, they also endure more severe and distressing symptoms. For instance, GERD symptoms during the night can hinder a good night’s sleep.

Gastroesophageal reflux disease symptoms include:

• Pain in the chest
• Persistent cough
• Challenges with swallowing
• Sleep disturbances
• Sensation of a lump in the throat
• Heartburn after eating, which intensifies in the evening
• Laryngitis
• Asthma symptoms
• Reflux of food or a sour-tasting liquid

If left untreated, GERD can elevate the possibility of esophageal cancer and provoke esophagitis, which could result in bleeding and ulcers in the esophagus.

Dietary Guidelines for GERD

People with gastroesophageal reflux disease should adopt dietary habits similar to those recommended for acid reflux to reduce the frequency of heartburn episodes. While there isn’t a universally recognized GERD diet, incorporating specific foods into your diet could alleviate symptoms. Finding an effective diet may require some experimentation. Consider consulting your healthcare provider or a nutrition expert for recommendations.

Mealtime suggestions to avoid GERD symptoms include:

• Maintain an upright posture while consuming food, and avoid lying down for at least 2 hours after eating.
• Limit alcohol consumption. Alcohol can impair the esophageal sphincter’s function and upset the stomach.
• Go for a short walk after meals to help the gastric juices move
• Make sure your final meal is consumed at least 3 hours before lying down or sleeping.
• Keep a record of foods that aggravate your GERD symptoms. This will help you minimize or exclude them from your diet.
• Chew gum (excluding peppermint and spearmint flavors). The chewing movement increases saliva, which neutralizes esophageal acid.
• Avoid foods rich in fats, chocolate, caffeine, fizzy drinks, and alcohol. Instead, focus on high-fiber, low-fat options, like lean meats, vegetables, whole grains, and healthy fats sourced from nuts, olive oil, and fish.

Popular Medications for GERD and Acid Reflux

When dietary and lifestyle modifications fail to relieve GERD and acid reflux symptoms, a healthcare provider may advise the use of medicine. Acid reflux medication and GERD medication can be accessed both as over-the-counter (OTC) options and by doctor prescription.

These medications primarily fall into three categories: proton pump inhibitors (PPIs), H2 blockers, and antacids.

People with mild or occasional reflux symptoms may find relief with OTC solutions. They can usually manage this independently with minimal input from a medical professional. However, there are people who suffer from severe GERD or intricate gastrointestinal conditions, like erosive esophagitis, gastritis, or ulcers in the gastrointestinal tract. For these conditions, prescription medications are a better option. 

For those experiencing occasional heartburn or mild symptoms, OTC antacids might be sufficient. However, for more pronounced acid reflux or GERD symptoms, healthcare providers may recommend medications like H2 blockers or proton pump inhibitors. Antacids aren’t typically used for treating GERD.

H2 blockers are generally preferred for less severe conditions. However, some people will require more extensive stomach acid control, in which case proton pump inhibitors are the better choice. 

MEDICATION TYPE	HOW LONG THEY WORK	OTC OR PRESCRIPTION	COMMON SIDE EFFECTS
Antacids – Rolaids, Tums, Maalox, Mylanta	Works in about 5 minutes but only effective for about an hour	Over-the-counter for minor heartburn. Not effective for treating severe acid reflux or GERD.	Very minor side effects—diarrhea, nausea, constipation
H2 Blockers – Pepcid, Tagamet, Zantac (withdrawn from the market)	Work in about 30 mins and reduces acid for roughly 12 hours.	Over-the-counter and prescription options available for GERD and acid reflux	Constipation, diarrhea, muscle aches, abdominal pain, and headache
Proton Pump Inhibitors – Protonix, Prilosec, Nexium, Prevacid	Starts working in 1-4 days, but last for up to 24 hours.	Over-the-counter and prescription for the most severe cases of GERD and acid reflux.	Abdominal pain, headache, diarrhea, gas, and nausea

Proton Pump Inhibitor Side Effects

Proton pump inhibitors (PPIs) are effective in reducing stomach acid. And while many people tolerate PPI treatment well, there can be severe side effects, especially when consumed for extended periods. Over-the-counter PPIs are suggested for up to 14 days of use, whereas prescription versions can be taken for as long as eight weeks.

H2 blockers and proton pump inhibitors are typically well-tolerated by most patients. Occasional side effects with prolonged PPI use include an elevated likelihood of bone breaks, infections from Clostridium difficile bacteria, and stomach-related cancers.

Additionally, the National Kidney Foundation highlights that PPIs can heighten the risk of significant kidney issues, like chronic kidney disease and acute interstitial nephritis, which is an inflammation within the kidneys. Those with kidney conditions should avoid PPIs. The associated kidney risks have sparked lawsuits against PPI manufacturers.

Zantac, NDMA Contamination, and Cancer

In early 2020, the U.S. Food and Drug Administration instructed pharmaceutical companies to remove all Zantac products and its generic version, ranitidine, from store shelves due to the detection of N-Nitrosodimethylamine (NDMA) in samples of the medication. 

NDMA, a substance proven to be carcinogenic in animals, might also pose cancer risks to humans. Based on animal-based research revealing its carcinogenic nature, the International Agency for Research on Cancer labeled NDMA as a likely carcinogen to humans.

While the FDA has yet to confirm any cancer cases resulting from Zantac usage, several individuals have initiated legal actions against its manufacturers, claiming the drug was responsible for their cancer diagnoses. Most of these claimants lacked any genetic predisposition or familial history of cancer, as stated by their legal representatives.

The types of cancers cited in the lawsuits in connection to Zantac include:

• Bladder cancer and subsequent bladder removal
• Breast cancer
• Colon cancer
• Esophageal cancer
• Kidney cancer and subsequent kidney removal
• Liver cancer
• Melanoma
• Ovarian cancer
• Prostate cancer
• Stomach cancer

It’s natural for people to be concerned about medication safety. However, it’s reassuring to note that the overall risk to someone using these drugs is incredibly minimal. Additionally, there’s a variety of alternative treatments available for addressing reflux, heartburn, and other gastrointestinal conditions.

Should I Call My Health Care Provider About Medication Side Effects? 

Medication inserts list a number of side effects, which can be both helpful and confusing for patients. 

It’s important to be cautious when taking any medication. You should always communicate any health concerns you may have with a medical professional, who can guide you on the safety precautions you can take as it relates to taking medications. 

There’s always the potential to overuse any drug. That’s why it’s important to review the risks and benefits of each medication to determine its necessity. 

What is the Safest Acid Reflux Medication? 

Generally, the medications for acid reflux and GERD are considered safe for the majority of patients. However, every drug comes with potential side effects, and not all are universally safe. Some medications may have fewer or less severe side effects.

People with questions about medication safety should consult a medical expert. Your healthcare provider will be able to help you identify the most appropriate and safe medication for your needs. 

There are cases where patients may be on medications unnecessarily, some of whom may be able to stop taking medicine entirely. However, these decisions need to be discussed with a healthcare professional beforehand. In other situations, patients may choose to continue taking their current medication with an understanding of its risks, or may opt for an entirely different treatment. 

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