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Acid reflux is one of the most common reasons people seek medical care.
вЂњAcid refluxвЂќ is a term used to describe the upward movement of acidic stomach contents into your esophagus, which is the hollow tube connecting your throat and stomach. The most common symptoms reported by people with acid reflux are heartburn and regurgitation. About 40 percent of American adults experience heartburn at least once monthly, and many of these people turn to over-the-counter medications to relieve their discomfort. If your acid reflux symptoms persist, prescription-strength medications may be warranted.
Proton Pump Inhibitors
Proton pump inhibitors are arguably the most effective medications for managing acid reflux. These drugs, many of which are available over the counter, block the cellular pumps in your stomach that help produce hydrochloric acid. If your doctor prescribes a PPI - omeprazole (Prilosec), lansoprazole (Prevacid) and pantoprazole (Protonix) are examples - it may be much stronger than the doses you can obtain over the counter.
The most common short-term side effects of PPIs include headache, abdominal pain, gassiness, muscle aches, nausea, diarrhea and constipation. Long-term side effects of PPIs, such as increased risk for hip fracture or vitamin B12 deficiency, are still a matter of some debate. A 2010 review in "Current Gastroenterology Reports" reiterated many researchers' concerns that PPIs decreased calcium, iron, magnesium and vitamin B12 absorption when taken for extended periods of time. Your doctor will help you decide if long-term, high-dose PPI therapy is appropriate for you.
H2 blockers are another class of over-the-counter drugs that may be prescribed in higher doses by your physician. Cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid) and other H2 blockers reduce acid secretion by blocking histamine receptors in the lining of your stomach. While not as effective as PPIs, H2 blockers are sufficient for controlling acid reflux in many patients. In cases where acid reflux is particularly troublesome, physicians may prescribe both H2 blockers and PPIs.
Nausea, diarrhea, constipation, gassiness and abdominal pain are the most common side effects of H2 blockers. Some men may develop breast enlargement when taking these medications. As is the case with PPIs, some evidence indicates that long-term use of H2 blockers may interfere with absorption of acid-dependent nutrients, such as calcium and vitamin B12. A study published in the July 2010 issue of "Gastroenterology" showed that both PPIs and H2 blockers, when used for more than two years, may increase your risk for hip fracture if you have other risk factors for hip fracture, such as diabetes or alcohol abuse.
If acid reflux persists despite the use of PPIs or H2 blockers, your doctor may prescribe a medication to move things through your stomach more quickly. This helps prevent reflux by encouraging forward movement of stomach contents and keeping your stomach empty. Metoclopramide (Reglan) is the most commonly prescribed prokinetic drug. Cisapride (Propulsid) is another, but cisapride is only available to carefully selected patients, as it has been linked to abnormal heart rhythms in certain people.
Prokinetic agents have potentially serious side effects, which is why they are available by prescription only. Involuntary movements of the face and tongue, tremors, disruption of menstrual cycles, fluid retention, nipple discharge and depression are among the many side effects of metoclopramide. Your doctor will prescribe prokinetic drugs only if their benefits outweigh their risks.
Acid reflux is one of the most common reasons people seek medical care. In fact, gastroesophageal reflux disease, which is characterized by persistent heartburn or a complication caused by reflux of stomach contents into your esophagus, is the most common gastrointestinal disease in Western society. If you have persistent symptoms of acid reflux, see your doctor. Some complications of persistent reflux, such as esophageal scarring, can be serious. Prescription medications or referral for further evaluation may be warranted.