There are two major categories of medication used to treat reflux ie antacids and acid suppressants.
Antacids
As their name implies these are alkali liquids or tablets that simply neutralise the acid in the stomach. A single dose usually gives quick, though temporary, relief. There are many brands available, some of which require a doctors’ prescription. Common examples are Rennies®, Alka-Seltzer®, Gaviscon® and Tums®. You can use antacids 'as required' for mild or infrequent bouts of heartburn.
Acid-suppressing drugs
If your symptoms are peristent, you are likely to be prescribed a drug that will actually reduce acid production in the stomach. Two types of acid-suppressing drugs are available - proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers). They work in different ways but both block acid secretion and so help reduce heartburn and other symptoms of GORD.
H2 Common H2 blockers include: H2 blockers include: cimetidine, famotidine, nizatidine, and ranitidine. Unfortunately, H2 blockers have limited effectiveness and, since they only work for 8-12 hours, taking an H2 blockers in the morning may not prevent acid production and heartburn later in the day.
Nowadays, a PPI tends to be the treatment of choice because these drugs have a longer duration of action and are more potent at suppressing acid than H2 blockers. PPI’s include: omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole.
A common initial plan is to take a full dose course of a PPI for a month or two. This often settles symptoms down and allows any inflammation in the oesophagus to clear.
However, some people need long-term daily acid suppressing treatment, without which their symptoms quickly return. Long-term treatment with an acid-suppressing drug is thought to be safe, and side-effects are uncommon.
It is important to note, however, that while each of these medications may reduce the symptoms associated with acid reflux, they do not restore the function of the LES which - as we have seen - is the body’s natural barrier between the stomach and the esophagus. Therefore, while acid-related symptoms may be reduced, the underlying problem with the LES remains.
In a small group of people, acid-suppressant treatment – even at maximum doses - is no longer sufficient to control their symptoms. If you are one of these, then you may be thinking about a surgical option.
