Antacids - Uses, Mechanisms and Who should Avoid

Indigestion is often caused by your stomach producing too much acid, which can irritate the lining of your stomach. Symptoms can include feeling bloated and full, belching, flatulence, feeling sick, pain and discomfort in your upper abdomen, and heartburn. Symptoms usually occur after eating or drinking and can be more common at night (especially heartburn). Heartburn is the result of stomach acid travelling up your oesophagus (food pipe). This effect is known as acid reflux. The acid irritates the lining of your oesophagus, resulting in a burning feeling in your chest. Antacids work by neutralising stomach acid, reducing how much it can irritate the stomach lining.

Taking an antacid is straightforward, but it’s important to follow the instructions to get the best results. Most antacids come in either liquid form or chewable tablets. If you're using liquid antacid, give the bottle a good shake before each use to ensure the ingredients are properly mixed. For tablets, simply chew them thoroughly before swallowing—don’t swallow them whole, as they may not work as effectively.

It’s typically recommended to take an antacid after meals and before bed, as this is when your stomach produces the most acid. If you're using it for heartburn or indigestion, taking it about 1 hour after eating can help relieve the discomfort.

Be mindful of the dosage and how often you take it. Antacids can sometimes cause side effects like constipation or diarrhea, so avoid taking them more often than recommended. If you’re on any other medications, check with your doctor or pharmacist to make sure there are no interactions.

Lastly, if you find yourself relying on antacids regularly, it’s worth having a chat with your doctor. Persistent symptoms might indicate an underlying issue that needs more targeted treatment.

How Long Should You Use Antacids?

Antacids are generally safe for short-term use but shouldn’t be relied upon long-term without professional guidance. Antacids can offer quick relief if your symptoms are occasional—perhaps triggered by a large meal or a night of indulgence. However, if you're reaching for them regularly, it might be time to take a closer look at the underlying cause of your discomfort. Overuse of antacids can sometimes lead to more serious issues, like altering your body’s natural acid-base balance or affecting the absorption of certain nutrients.

For example, excessive use of calcium-based antacids can contribute to high calcium levels in the blood, while overuse of magnesium-based ones might lead to diarrhoea. Consistently taking antacids without addressing the root cause of your symptoms can also mask more serious conditions, such as ulcers or gastro-oesophageal reflux disease (GERD). These issues might need different treatments or long-term management strategies.

If you frequently use antacids or your symptoms persist for more than a couple of weeks, it’s important to consult a healthcare professional. They may recommend an alternative treatment, such as proton pump inhibitors (PPIs) or H2 blockers, which target acid production more directly for long-term relief. They can also assess whether your symptoms are due to another condition that requires different management, such as a bacterial infection or inflammation in the digestive tract.

Do not take an antacid product if you are allergic to any of the ingredients in it. Age restrictions vary between different antacid products, so make sure you follow the specific guidance for each product.

You should speak with your doctor or pharmacist before taking an antacid if you have liver or kidney problems, heart failure, or have been recommended to follow a diet low in calcium, sodium, or potassium. Not all antacid products are suitable if you are pregnant or breastfeeding, but Gaviscon and Rennie are.

Antacids can interact with other medications. If you take any prescription, over-the-counter, or herbal medications, you should ask your doctor or pharmacist whether it is safe to take them alongside an antacid. They may recommend you take your usual medications at a different time to an antacid.

Can Antacids Interfere with Other Medications?

Antacids can interact with a range of other medications, which is an essential consideration before starting them, especially if you take prescription drugs. Certain medications—like antibiotics, blood pressure medication, and thyroid medications - can be less effective when taken alongside antacids. This is because the neutralising effect of antacids can interfere with the absorption of these drugs in your stomach.

For instance, antacids can reduce the effectiveness of drugs like tetracycline antibiotics, leading to less effective treatment of infections. They can also impact how your body processes certain heart medications or medications for osteoporosis. If you're on medication for any chronic condition, it's wise to talk to your doctor or pharmacist about the best times to take both your antacids and other prescriptions. They may recommend spacing them out to ensure that each one works as intended.

In some cases, antacids might need to be avoided entirely. For example, those with kidney problems should be cautious when using magnesium-based antacids, as their kidneys may not process the mineral effectively, leading to potentially harmful levels in the bloodstream. Always check the packaging of your antacid, and when in doubt, consult with your healthcare provider to avoid any issues with drug interactions.

Like any medication, antacids can cause side effects, though not everyone will experience them. The most common issues include feeling nauseous and vomiting, bloating, or stomach cramps. Some people may also experience changes in bowel movements, such as diarrhoea or constipation.

The specific side effects can depend on the type of antacid you’re using. For example, those with magnesium may cause loose stools, while calcium-based antacids can lead to constipation. If these effects become uncomfortable or persistent, it’s a good idea to talk to your doctor or pharmacist. They can help you find the right solution, whether it’s a different type of antacid or another treatment for your symptoms.

If you’re taking antacids frequently and notice any unusual symptoms, like confusion, muscle weakness, or changes in mood, it’s important to seek medical advice, as these could be signs of a more serious issue, especially with prolonged use.

Alternatives to Antacids

If you find that antacids aren't providing relief, or are experiencing too many side effects, or if you need something for longer-term management, there are other options available. Medications proton pump inhibitors (PPIs, such as omeprazole, lansoprazole and esomeprazole) can be prescribed or even bought over-the-counter to help reduce stomach acid production, providing longer-lasting relief. These options are often recommended for those dealing with persistent heartburn or acid reflux.

Alongside medication, lifestyle changes can also make a significant difference. Reducing alcohol consumption, quitting smoking, and eating smaller meals can help lower the frequency of acid reflux and indigestion. Avoiding trigger foods, such as spicy or fatty foods, and staying upright after eating can also reduce the risk of acid irritating your stomach lining.

In addition, stress management techniques—like regular exercise, yoga, or mindfulness—can play a crucial role in preventing digestive issues. When stress levels are high, your stomach produces more acid, which can exacerbate symptoms. Taking a holistic approach, rather than relying solely on medication, can help maintain long-term digestive health.