GERD And Other Acidity Disorders In Simple Terms
Leakage of acidic stomach contents into the esophagus causing heartburn (chest burn) and / or acid reflux. These are called reflux symptoms. Reflux problems can occur sporadically in perfectly healthy. For recurrent reflux symptoms, it is important to distinguish between the Gastroesophageal Reflux Disease (GERD) and secondary reflux:
In GERD, there is a defective valve between the stomach and esophagus, which often provokes a characteristic symptom picture with mainly esophageal disorders. In secondary reflux, e.g. for ulcer disease or functional dyspepsia, acid reflux is only a part of the entire picture of dyspeptic symptoms, that is, other symptoms of upper GI tract exists. When GERD is almost always a hiatus of slide type and the resting pressure of the lower esophagus sphincter is often lowered. The cause of hiatus hernia is not known. At the secondary reflux hiatus hernia is often not there and reflux is mainly attributed to a disturbed ventricular motorics than a defective valve.
Heartburn / acid reflux occurs regularly:
- After a meal
- During forward flexion
- When standing up
- When lying down.
Epigastric pain is often absent from the picture. The disease is usually chronic with either continuous or intermittent symptoms.
Atypical symptoms that can occur with GERD are:
- Esophageal (retrosternal) pain of non-stinging type
- Swallowing difficulties (due to peptic stenosis or esophageal motor disorders)
- Cough, hoarseness.
In secondary reflux there often occurs heartburn often irregularly without clear relation to the above situations reflux and pain in the epigastric exists almost always. Note that hiatus hernia in itself causes any pain very rarely and not everyone with hiatus hernia has reflux symptoms.
Acid Reflux Drugs Classification
Antacids. Medicines that neutralize the acid called antacids. Samarin is an example of antacids containing sodium bicarbonate. Bicarbonate gives temporary relief of symptoms, but is also taken up in the blood and can affect the pH of the body when using the funds often. Therefore, one should not use antacids with baking soda more often than a few times per day, and not longer than two weeks.
If you have trouble often should first choose the so-called buffering antacids, especially antacids with bicarbonate. That it is buffering means that the drugs do not raise the pH in the stomach too much and that they are not absorbed into the bloodstream. This makes it possible to take them up to 10-15 times a day. But one needs to take medication as often, it is better to take proton pump inhibitors and histamine-2 blockers.
Alginic Acid. Alginic acid forms a sort of gelatinous mass that settles on top of the stomach. It allows the stomach contents will not easily rise up into the esophagus. The medication thus reduces the risk of reflux. The effect lasts for about three hours. Alginic acid is not absorbed from the intestine but leaves the body as waste. Alginic acid found in drugs Galieve and Gaviscon. Both can be bought without a prescription. You can combine alginic acid with antacids. Alginic acid needs to do some good. Therefore, it is important to take first alginic acid, about half an hour before taking antacids.
Histamine-2 blockers. Histamine-2 blockers, so called H2-blockers, is a type of drugs that block nerve to the cells that produce hydrochloric acid in the stomach. This reduces the secretion of hydrochloric acid. Histamine-2 blockers get the maximum effect little faster than the PPI, but are not as effective. In the selection of these drugs, it is thus important to make an assessment of what is most important – speed or efficiency. Histamine-2 blockers can be combined with antacids.
There are prescription drugs for the treatment of reflux symptoms. Examples of histamine-2 blockers are medicines containing the active substance ranitidine, such as Ranitidine and Zantac, or medicines that contain the active ingredient famotidine, such as Pepcid. Some histamine-2 blockers are available as effervescent tablet. Maximum power comes after one to three hours and lasts for about twelve hours. There are combination of histamine-2 antagonists and antacids, which can be used if one wants faster effect. An example of this is Pepcid Duo.
Proton pump inhibitors. Proton pump inhibitors decrease acid production sharply than histamine-2 blockers. There is no big difference in efficacy between the various PPIs for the treatment of reflux symptoms. Examples of proton pump inhibitors are drugs which contain the active substance omeprazole, such as omeprazole and Losec, or substance pantoprazole, such Nexium and Prevacid. Another name for the proton pump inhibitor is the abbreviation PPI.
Some proton pump inhibitors can be purchased without a prescription in smaller packages. If you regularly have need of proton pump inhibitors, it will be cheaper per tablet if you get prescriptions from their doctor on larger packages through a service like our Canadian Pharmacy.
To get the best effect of proton pump inhibitors should take them half an hour before the first food, no matter what time of day the appeal is greatest. It takes one to three hours before the drug starts to work, and a few days before you get the full effect. If you want a faster effect is therefore antacids better. If you want to take antacids at the same time to reduce symptoms faster, that’s fine.
Usually proton pump inhibitors are first-line defense in acute disease. If you have mild and moderate symptoms is generally enough to histamine-2 blockers and antacids to become symptom free. Treatment depends on how much trouble you have. Therefore, one should itself be involved in the treatment.
When you have severe reflux symptoms, the doctor usually a prescription of PPIs. The symptoms diminish or disappear usually within a few days. If you have very severe symptoms may need regular treatment for longer. When the discomfort is gone, you can use proton pump inhibitors as needed. You do not generally take them regularly. It is good to consult with your doctor about how often to take the medication. If you have typical reflux symptoms that are not relieved by proton pump inhibitors and histamine-2 blockers may be due to bile salts from the bile ducts backs up to the esophagus, but it is unusual. Antacids then usually help. If you have reflux symptoms that are not relieved by proton pump inhibitor or histamine-2 blockers should consult their doctor.
If you get a severe inflammation of the esophagus may need high doses of proton pump inhibitors. Reflux problems are usually relieved by PPIs and get no effect should be investigated further, for example with the so-called 24-hour pH measurement. Symptoms may for example be caused by functional dyspepsia and there is acid suppressants no effect.
Safety Note Of Acid Reflux Drugs
There are no major drawbacks to using drugs for acid reflux. Taking histamine-2 blockers and proton pump inhibitors for two weeks or longer, you can sometimes get a so-called rebound effect. It means that you get increased production of hydrochloric acid and more symptoms when you stop taking the drug. If you encounter rebound effect may be necessary to take half the dose every day or the same dose every other day for a few weeks before you can stop taking drugs. You should consult with their doctor about what to do.
The risk is high that acid reflux symptoms will return despite having received treatment with drugs. Then you should avoid eating or drinking things that tend to aggravate the symptoms. It is good to eat regularly. You should also start with the drugs used in the past and that usually helps. It may be sufficient treatment a day or two for you then must cope without medication.
If you have had inflammation of the esophagus is sometimes required regular treatment with proton pump inhibitors. It is in the health food a lot of different alternative treatments for acid reflux symptoms. There are no scientific studies on the treatment has any effect or not.
It is common to have reflux symptoms while pregnant. This is because the increased pressure in the abdomen resulting from pregnancy and that the cardia becomes flaccid.
Proton pump inhibitors, antacids and alginic acid may be used during pregnancy. As for histamine-2 blockers, there is not enough experience in the treatment of pregnant and you should therefore consult a doctor if you need to use the drug while pregnant. If you have not had reflux symptoms before pregnancy, it is good to consult with a doctor or midwife at the antenatal clinic for appropriate treatment.
One should avoid histamine-2 blockers while breastfeeding. The active substance passes into breast milk and may affect the baby. The same applies if you are using proton pump inhibitors and therefore you should consult your doctor if you need to use some of the drugs while breastfeeding.