Antacids Alginic acid

Heartburn and Acid Reflux Cure Program

Stop Acid Reflux Naturally

Get Instant Access

Antacids work locally to increase the pH of the reflux-ate, neutralizing the acid. The increase in pH-causes pepsin to become inactive, and may also prevent the

Table 6. GERD therapy in the elderly




Antacids/Alginic acid

- Relief of mild/moderate symptoms (20%)

- Over the counter

- Rapid effect

- Do not heal mucosal disease

- Diarrhea/Constipation

- Impaired drug absorption

- Must be upright for effect (alginic acid)

Prokinetic agents

- Effectively relieve symptoms

- Heal mucosal erosions

- Useful for dyspeptic symptoms - nausea, gas, bloating

- As effective as H2B's

- Fatal arrhythmias (Cisapride)

- Poor side effect profile - crosses blood-brain barrier (CNS toxicity)

- Anti-cholinergic effects (Bethenechol)

Mucosal protective

- Provides symptom relief and esophageal healing

- Dosing four times a day

- Affects drug absorption

- Drug-drug interactions

Histamine2 receptor blockers

- Blocks acid production secondary to multiple stimuli

- Incomplete acid suppression

- Tolerance development

- Not as effective for erosive esophagitis

- May require increased dosing for full effect

- Dosage adjustment in renal failure

- Short duration of action

Proton pump inhibitors

- Blocks final common pathway of acid secretion

- Symptom relief and mucosal healing in up to 95%

- Effective in severe disease

- Once daily dosing

- Effective for maintenance therapy

- No dosage adjustments in renal or hepatic failure

- Increased gastrin production

- Possible alteration of gastritis pattern in H. Pylori positive patients

- Drug-drug interactions are possible

- Decreased vitamin B12 levels

injurious effects of certain bile acids [71]. They may increase LES pressure, decreasing the amount of gastroesophageal reflux. Alginic acid forms a foamy barrier on top of the refluxate to protect the esophagus from acid-induced damage. These agents have been shown to be more effective than placebo in providing relief of mild to moderate reflux symptoms [20]. Relief of symptoms can be expected in up to 20% of patients. Antacids and alginic acid are not likely to promote healing of the esophageal mucosa, or any other complications of chronic GERD [2]. There are some adverse effects, which may be of particular concern in the elderly, including constipation with aluminum containing preparations and diarrhea with magnesium containing products. Combination products may lessen these effects. Aluminum containing antacids can cause dialysis encephalopathy and osteomalacia, and should be used with caution in those with renal impairment. Antacids may promote salt overload, induce hypercalcemia, and affect absorption of other drugs, especially antibiotics [10]. In addition, alginic acid requires a patient to be in the upright position to be efficacious, which may be an issue in an elderly population. Antacids should not be use for more than 2 weeks, as this may hide a more severe diagnosis requiring endoscopic evaluation, and more aggressive medical management [72].

Was this article helpful?

0 0
Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

Get My Free Ebook

Post a comment