- 1. Antacids
- 2. Inhibitors of acid production
- Proton pump inhibitors
- Histamine H2 receptor antagonists
- 3. Accelerators of gastric emptying
- 4. Gastric protectors
One of the ways to treat gastroesophageal reflux is to decrease the acidity of the stomach contents, so that it does not harm the esophagus. So if the reflux is less acid it will burn less and cause less symptoms.
The drugs that can be used are antacids, inhibitors of acid production, protectors of the stomach and accelerators of gastric emptying.
1. Antacids
The most commonly used antacids to neutralize hydrochloric acid in the stomach are aluminum hydroxide, magnesium hydroxide and sodium bicarbonate. These remedies are bases that react with acids, reducing their toxic potential and giving rise to water and salt.
Antacids are not used as often because they are not as efficient and because there is a possibility of a rebound effect, that is, the person improves immediately but then there may be a worsening.
The most common side effects of these medications are constipation, which are caused by aluminum salts, or diarrhea that is caused by magnesium-containing antacids, as they cause an osmotic effect in the intestine. To minimize these side effects, the most used antacids are combinations of magnesium hydroxide and aluminum.
2. Inhibitors of acid production
Inhibitors of acid production are the remedies most used in the treatment of gastroesophageal reflux and can inhibit this production in two ways:
Proton pump inhibitors
These are the main remedies used to treat diseases related to increased gastric acid secretion. The most used are omeprazole, pantoprazole, esomeprazole and rabeprazole, which interfere with the proton pump, inhibiting the production of hydrochloric acid in the stomach.
The most common adverse effects that can occur with the use of these medications are headache, diarrhea, rashes, abdominal pain, flatulence, nausea and constipation.
Histamine H2 receptor antagonists
These drugs inhibit the acid secretion induced by histamine and gastrin and the most used are cimetidine, nizatidine and famotidine.
The most common adverse effects caused by the use of these drugs are diarrhea, headache, drowsiness, tiredness, muscle pain and constipation
3. Accelerators of gastric emptying
When the stomach is very full, gastroesophageal reflux is more likely to occur. So, to avoid this, gastrointestinal motility can be stimulated with prokinetic remedies such as metoclopramide, domperidone or cisapride that help with gastric emptying, thus decreasing the time the food remains in the stomach, preventing reflux.
The most common side effects that can occur with the use of metoclopramide are drowsiness, feeling of weakness, agitation, low blood pressure and diarrhea. In addition, although rarely, gastrointestinal disorders may occur with the use of domperidone and cisapride.
4. Gastric protectors
Gastric protectors can also be used to treat gastroesophageal reflux, which protect the esophagus, preventing burning when the contents in the stomach pass into the esophagus.
Generally, the organism has a mechanism in which it produces a mucus that protects the stomach lining, preventing the acid from attacking it, but in some pathological states and with the use of some medications, the production of this mucus can decrease and provide the aggression of the mucous. The gastric protectors that can be used to replace this mucus are sucralfate and bismuth salts that enhance the stomach's defense mechanisms and form a protective barrier in the stomach and esophagus.
The most common adverse effects caused by bismuth salts are the darkening of stools, dizziness, headache, nausea, vomiting, diarrhea and psychotic disorders.
Sucralfate is generally well tolerated and its main adverse effect is constipation. However, it can also cause dry mouth, nausea, vomiting, headache and skin rashes.
There are also home remedies that can contribute to successful treatment. Find out which ones are most used.
