Stomach acid is strong stuff. You don’t notice it when it behaves as it’s supposed to. But when something goes wrong, your stomach fluid can cause discomfort, pain or burning.
Some people will experience this as acid reflux, also called gastroesophageal reflux (GER), which can cause heartburn. This happens when stomach acids travel back into your esophagus, the tube that carries liquids and food from your mouth to your stomach. If GER occurs often, it might be considered GERD (the D is for “disease”), which is a chronic form of acid reflux.
GERD is classified as severe reflux that occurs at least once a week or mild reflux at least twice a week, according to the Mayo Clinic.
Another common condition that occurs in the gut is indigestion. This is a more general term that can describe an upset or burning stomach, bloating, feeling too full or too much burping.
Indigestion is common. It affects about 1 in 4 people in the U.S., according to the National Institutes of Health. And while it may occur alongside heartburn, it’s a separate condition.
With either indigestion or GER, your doctor may recommend an over-the-counter (OTC) antacid for relief. But how often, and for how long, is it safe to take them? That’s the question we put to Stephanie Linstedt, PharmD. She’s a clinical pharmacist in Optum’s Clinical Engagement Services. Here, she lays out everything antacid users should know.
Another thing you should know: how to save money on prescription medication. Download the Optum Perks mobile app and you can search for discounts anytime, anywhere.
Why do people take antacids?
Linstedt: For relief from indigestion, upset stomach or acid reflux. People can experience these conditions for many reasons. It could be caused by another condition or medication. It could also be a response to something you ate or drank, how close to bedtime you eat or how large your meals are.
But the root cause for all these conditions is stomach acid. And antacids help by neutralizing that acid.
Related reading: How to tell the difference between an ulcer and GERD.
Why are antacids so popular?
Linstedt: They’re easy to find and inexpensive. Plus, they work. Antacids offer quick relief, and they’re generally safe when you take them as directed.
Antacids are available in multiple dosage forms, such as liquid, chewable gummies or tablets, and tablets that dissolve in water. And since you don’t need a prescription, you can get them almost everywhere.
What are some of the downsides of antacids?
Linstedt: Antacids give only temporary relief. Yes, they can ease discomfort from heartburn, indigestion, upset stomach or acid reflux. But if there’s an underlying problem, they won’t solve it.
And if your esophagus has been damaged by excess stomach acid, antacids can’t heal it.
How much of an antacid is okay to take?
Linstedt: It might seem as though you can use antacids as often as you want because they’re sold over the counter. But they’re not intended for long-term therapy.
The dose size varies from one product to another, so you should read the label to be sure you’re taking the medication as directed. You don’t want to exceed the maximum dosage. And if you’re taking it daily for 2 weeks straight, it’s time to see a doctor. You may have a medical condition that requires different treatment.
What are the side effects of overusing antacids?
Linstedt: Antacids are generally safe, and side effects are rare if you take them appropriately. But overuse or misuse can sometimes cause unwanted and even serious side effects. In rare cases, you could experience constipation, diarrhea, nausea or vomiting.
One potential downside of long-term heavy use is that the medication could put you at an increased risk for osteoporosis. Although rare, antacids with aluminum [such as Maalox and Mylanta] may deplete your calcium levels, which could cause your bones to become brittle.
At the same time, antacids with calcium carbonate [such as Tums and Rolaids] could have the opposite effect. They could elevate your calcium levels, which could lead to the development of kidney stones and kidney failure. Again, this is a rare side effect. But talk to your doctor if you have any concerns.
What are some alternatives to antacids for treating heartburn and acid indigestion caused by acid reflux?
Linstedt: If your symptoms are frequent or severe, your doctor may also recommend other medicine besides antacids. For example, OTC medicines called histamine-2 blockers may work better for you. These include cimetidine (Tagamet HB®) and famotidine (Pepcid AC®). [Here’s how H2 blockers could help soothe acid reflux.]
Proton pump inhibitors (PPIs) [for example, lansoprazole (Prevacid®) and pantoprazole (Protonix®)] are another option. These reduce the amount of acid your stomach makes, and they’re available over the counter and by prescription. Some doctors prescribe PPIs for long-term treatment.
Are there any non-medication options?
Linstedt: Sure there are. For starters, try to maintain a healthy weight. If you smoke, quit. And avoid foods and beverages that can make your condition worse, such as chocolate, coffee, acidic tomato products, greasy or spicy foods and alcoholic beverages.
Loose-fitting clothing can also help. And after a meal, don’t lie down for 3 hours. That might mean you need to plan an earlier dinnertime. And if you have acid reflux, sleep with your head elevated. You can do this by putting a foam wedge under the head of your mattress or extra pillows under your head and upper back to raise your head around 6 to 8 inches.
The good news is that antacids can really help. And if you take them occasionally and at the recommended dose, they rarely cause side effects. But you should talk to your doctor if you’re taking them frequently. You may need to discuss a better long-term solution.
[While you’re here, download the Optum Perks discount card. It’s free and easy to use: Just show it to the pharmacist and you could save money at checkout.]