Burning Issues for Antacid Drugs

Heartburn, indigestion, and acid reflux are popular ways of describing the pain caused by stomach acid. The burning sensation it produces ranges from discomfort to a searing pain that seems to be burning a hole in your body from back to front. Traditionally, you reach for the cheap antacids based on simple chemicals such as sodium bicarbonate, calcium carbonate and aluminium and magnesium compounds.

But, what if you suffer regularly and frequently? Or if the pain doubles you up, and the simple antacids just do not work for longer than a few minutes?

A trip to your doctor for diagnosis, just to make sure you are not suffering from any serious medical problem is best. I know that acid burning holes in you is serious, but then it is not cancer either. So, you need to know what you have got.

Once it is established that acid is at the source of your pain, the doctor usually prescribes one drug from a two groups of powerful acid fighters. These are the H2 receptor antagonists and the proton pump inhibitors.

Briefly, histamine joins on to special receptors called H2 in the stomach, causing cells to make acid. Molecules that attach to the same receptors but do not cause acid production are called H2 receptor antagonists. The drugs in this group include famotidine (Pepcid), ranitidine (Zantac), cimetidine (Tagamet) and nizatidine (Axid).

The proton pump is the name given to the part of the acid producing process in the stomach where special cells exchange hydrogen ions for potassium ions. The drugs in this group interrupt the process, thus cutting acid production. They include omeprazole (Losec/ Prilosec), esomeprazole (Nexium), lansoprazole (Zoton/ Prevacid), pantoprazole (Protonix) and rabeprazole (Pariet/ Aciphex).

These two groups of drugs have earned billions of dollars in sales and profits for their manufacturers over the years. But, are they as wonderful as the sales figures and advertising would have us believe?

The first thing to say is that they work. Yes, they cut your stomach acid production right down. The relief is great. No pain or discomfort, and life is wonderful once more.

But, take a look at the patient information leaflet you get with the drug. There is a list of possible side effects for you to mull over. The list includes headaches, constipation, diarrhoea and has a note of some of the other medicines that they interact with: things like warfarin for thinning blood, phenytoin for epilepsy, diazepam for anxiety, digoxin for heart problems and antifungal drugs.

Some of these could well be a stumbling block for taking these antacid drugs. More important is the idea that they do not actually solve the problem. Yes, they cut acid but something caused the acid in the first place. And that is what you really need to know about so you can change the cause, not just the symptoms.

More to the point, while you are taking them, your stomach acid is bound to be lower than it should be. You and I need acid in the stomach so we can digest food. And we need acid to protect us from poisoning and infections. The acid kills many bacteria, viruses and fungi we might eat on our food. So, taking the drugs longterm allows some bacteria to cause illnesses we might otherwise not get.

Finally, taking these drugs for extended periods of time can set up changes in the way you keep acid in your stomach. Reduced acid production allows the trap door or sphincter at the stomach entrance to become weak and inefficient. This lets acid leak up into your oesophagus and cause damage there.

So, it is a dilemma. Let people suffer from too much acid or dose them up with drugs that could cause serious changes and problems later on. There is no simple answer. The ideal situation is to find the source of the problem and sort it. Perhaps you would be better using the drugs to give you time to investigate and sort the cause before it is too late.