Heartburn and indigestion are incredibly uncommon and affect most people on occasion. When their acid reflux is acting up, many people reach for common over the counter medications called antacids that help to reduce the painful and uncomfortable symptoms associated with acid reflux. These medications can be effective in the treatment of occasional mild to moderate acid reflux for many people, but few people understand how antacid works.

How Antacids Work

Antacids are over-the-counter (OTC) medications that are commonly used to treat occasional mild to moderate heartburn.

These medications are one of many options used for the treatment of heartburn, but antacids work differently from prescription heartburn medications such as proton pump inhibitors and H2 receptor blockers. Prescription treatments for heartburn typically work by stopping the stomach from producing as much stomach acid or reducing the amount of acid in the stomach.

By contrast, antacids work by neutralizing stomach acid. Antacids typically come in the form of liquids, chewable tablets, or tablets that are designed to dissolve into a beverage.

Antacids commonly contain active ingredients such as calcium, magnesium, and aluminum salts that help to reduce the pH of the stomach acid. In addition to neutralizing some of the acidity of stomach acid, antacids also inhibit the action of an enzyme called pepsin, which is used by the body to help digest protein. In addition to helping digest protein, pepsin also interacts with hydrochloric acid inside the stomach and contributes to creating the acidic environment that your stomach needs in order to properly digest food.

Some types of antacids include an additional ingredient called alginate, which creates a foam that floats at the top of the stomach and prevents acid from entering the esophagus.

Why People Use Antacids

There are many different reasons why people use antacids, but all of them relate to relieving the symptoms associated with excess acid in the stomach.

Common symptoms of excess stomach acid include:

• Heartburn, a condition in which excess stomach acid enters the esophagus, creating a burning sensation in the chest or throat
• Acid reflux, a general term used to describe symptoms of excess acid production such as pain when lying down, difficulty swallowing, bitter taste in the mouth, regurgitation, nausea, and persistent dry cough
• Indigestion, which includes symptoms like gas and bloating that affect the upper portion of the digestive tracts
  

Antacids During Pregnancy

Many women experience symptoms of heartburn during pregnancy as the expanding uterus pushes on the stomach, forcing stomach acid into the esophagus. While the symptoms of heartburn and acid reflux during pregnancy can be troubling, pregnant women must use caution when taking antacids.

Antacids containing sodium bicarbonate can have adverse effects on a growing baby and are not considered safe for use during pregnancy. Similarly, pregnant women should not use antacids that contain acid, as they contribute to an increased risk of bleeding.

However, pregnant women may use antacids that contain calcium carbonate, as this active ingredient is generally considered safe for use during pregnancy. However, pregnant women should always first speak to their doctor before taking antacids in order to ensure that their chosen antacid is safe for use during pregnancy.

Antacids for Kids

Less frequently, children may also experience acid reflux or heartburn.

Acid reflux is fairly common in infants, where it may result from food sensitivities.

In children, acid reflux can be caused by a wide variety of different factors, including obesity, developmental delay, and food sensitivities. Acid reflux in children is not considered normal and should be discussed with a doctor in order to determine a proper diagnosis and cause.

Children may not be able to use the same types of antacids as adults and should take anantacid that is specially formulated for kids.

Precautions for Antacid Use

Antacids are available over the counter without a prescription, which means that they are generally considered safe for most people when used as directed. However, some people may not be able to use certain types of antacids safely, including individuals with certain medical conditions. Antacids that contain aluminum hydroxide and magnesium carbonate are known to cause dangerous side effects in people with certain medical conditions.

Individuals experiencing kidney failure should not use antacids that contain aluminum hydroxide, as their kidneys may not be able to filter out the aluminum properly. As a result, they may develop a buildup of aluminum, which can cause aluminum toxicity. People with kidney disease or kidney failure also may have difficulty regulating their electrolyte levels, which can cause dangerous side effects. All antacids contain some type of electrolyte, so use of antacids may contribute to electrolyte imbalances in people with impaired kidney function.

Individuals experiencing heart failure may also not be able to use antacids safely due to the amount of sodium that is present in many antacids. Heart patients typically have sodium restrictions in place that are intended to minimize the buildup of fluid around the heart, so the addition of more sodium can be dangerous.

Antacid Side Effects

Antacids are a safe medication that is sold over the counter, so side effects are rare. However, it is possible to experience side effects associated with antacids even if you use the product according to the instructions.

The most common side effects associated with antacids include:

• Constipation, particularly when taking antacids that contain calcium or aluminum as the active ingredient
• Diarrhea, particularly when taking antacids that contain magnesium as the active ingredient
• Decreased bone mineralization, particularly when using a large amount of antacids that contain aluminum as the active ingredient
• Fluid retention or alkalosis, particularly when taking antacids that contain sodium bicarbonate as the active ingredient.

Rarely, some people have experienced allergic reactions while taking antacids. Other individuals have developed sensitivities to certain foods when using antacids regularly.

Another potentially serious side effect associated with antacids that contain aspirin is a serious risk of bleeding. The FDA issued a warning in 2016 that specifically addressed the risk of bleeding, particularly in individuals over the age of 60 and in people who have bleeding disorders or a history of stomach ulcers.

While antacids can cause side effects when taken as directed, some side effects associated with antacids occur as a result of misuse, such as when the products are taken for too long or in too large of a quantity.

Antacids containing calcium carbonate as the active ingredient can cause an overdose of calcium when used incorrectly. Calcium overdose can cause side effects including:

• Nausea
• Changes in mental status
• Vomiting
• Kidney stones
• Alkalosis, a condition in which the body does not produce enough acid to function properly

Antacids are intended for occasional use only. If you find that you need to take antacids in large quantities or for an extended period of time, your acid reflux may be serious or you may be suffering from another condition. Talk to your doctor if you do not find relief from taking antacids as directed.

Antacid Drug Interactions

Antacids contain ingredients that can interfere with the function and effectiveness of other medications, so it is important to give your doctor and pharmacist a complete list of all medications and supplements that you are taking before using antacids.

Antacids that contain aspirin are associated with an increased risk of serious bleeding. Therefore. They should not be used by patients who take medications that increase their risk of bleeding, including anticoagulants (blood thinners) or antiplatelet drugs.

When to Talk to a Doctor

Antacids can be very helpful in reducing symptoms of occasional mild to moderate heartburn, acid reflux, and indigestion.

However, if you find that you need to use antacids in larger quantities than directed or for an extended period of time, you may be experiencing a more serious medical condition, such as gastroesophageal reflux disease (GERD) or a peptic ulcer. These conditions have potentially serious consequences to your health if left untreated, so make sure to talk to your doctor if your symptoms persist.

Antacids provide relief from symptoms, but they do not cure or prevent the causes of acid reflux. If your symptoms last for more than two weeks and remain severe, it’s time to call your doctor.

However, there are some steps that you can take in order to minimize your likelihood of experiencing symptoms of acid reflux, including:

• Maintaining a healthy weight
• Avoiding eating late at night
• Sleeping in an inclined position rather than lying flat
• Avoiding eating fried or fatty foods
• Avoiding eating chocolate
• Avoiding eating peppermint
• Avoiding consuming caffeinated beverages like coffee
• Avoiding consuming acidic foods like lemons, tomatoes, and citrus

Summary

It’s normal to experience occasional acid reflux or heartburn, and antacids can help by neutralizing stomach acid to reduce symptoms. However, antacids are not intended to cure or prevent the causes of acid reflux and should not be used for longer than directed or in a higher dose than directed, as they can cause potentially dangerous side effects.