Acid Reflux
Did you know?
At the entrance to your stomach is a valve, which is a ring of muscle called the lower esophageal sphincter (LES). Normally, the LES closes as soon as food passes through it. If the LES doesn't close all the way or if it opens too often, acid produced by your stomach can move up into your esophagus. This can cause symptoms such as a burning chest pain called heartburn. If acid reflux symptoms happen more than twice a week, you have acid reflux disease, also known as gastroesophageal reflux disease (GERD).
What Causes Acid Reflux Disease?
One common cause of acid reflux disease is a stomach abnormality called a hiatal hernia. This occurs when the upper part of the stomach and LES move above the diaphragm, a muscle that separates your stomach from your chest. Normally, the diaphragm helps keep acid in our stomach. But if you have a hiatal hernia, acid can move up into your esophagus and cause symptoms of acid reflux disease.
These are other common risk factors for acid reflux disease:
-Eating large meals or lying down right after a meal
-Being overweight or obese
-Eating a heavy meal and lying on your back or bending over at the waist
-Snacking close to bedtime
-Eating certain foods, such as citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods
-Drinking certain beverages, such as alcohol, carbonated drinks, coffee, or tea
-Smoking
-Being pregnant
-Taking aspirin, ibuprofen, certain muscle relaxers, or blood pressure medications
Read all about acid reflux and GERD here
OTC Treatment Options:
Immediate relief of acid reflux (heart burn/indigestion) Antacids and H2 blockers
Antacids:
H2 Blockers (histamine 2 receptor blocker- h2 releases acid into the stomach, these drugs work by attaching to the histamine receptor and preventing release of gastric acid into the stomach for immediate relief)
1) ZANTAC (ranitidine 75-150mg twice daily)
2) PEPCID (famotidine 10-20mg every 12 hours; max dose of 40mg per day with no degree of kidney impairment and max dose of 20mg per day if CrCl is < 50ml/min
3) TAGAMET (cimetidine 200mg per day; max dose of 400mg per day)
Special instruction: has many drug interactions; avoid use with cefuroxime, dasatinib, delavirdine, dofetilide, epirubicin, neratinib, pazopanib, pimozide, risendronate. Avoid use with severe kidney impairment.
GERD OTC Treatment Options (H2 Blockers and PPIs)
H2 Blockers (higher doses for GERD vs. immediate relief for indigestion):
1) ZANTAC (ranitidine 150mg twice daily)
2) PEPCID (famotidine 20mg every 12 hours for 6 weeks; max dose of 40mg per day with no degree of kidney impairment and max dose of 20mg per day if CrCl is < 50ml/min)
3) TAGAMET (cimetidine 400mg four times daily or 800mg twice daily for 12 weeks)
Tagamet Special instruction: has many drug interactions; avoid use with cefuroxime, dasatinib, delavirdine, dofetilide, epirubicin, neratinib, pazopanib, pimozide, risendronate. Also avoid use with severe kidney impairment.
Proton Pump Inhibitors (PPI) (prevents secretion of gastric acid into the stomach by blocking acid in the gastric parietal cell)
1) PRILOSEC (omeprazole 20mg once daily for up to 4 weeks)
2) NEXIUM (esomeprazole 20mg once daily for 2 weeks)
3) PREVACID (lansoprazole 15mg once daily for up to 8 weeks)