Antacids: Types, Symptoms, Precautions and Side Effects

Antacids are a type of drug that helps to neutralize stomach acids. These tablets contain substances such as calcium, sodium bicarbonate, aluminium, and magnesium, which act as alkalis or bases in the stomach, neutralizing the pH. Until 1970, the only way to address acidity was to take antacids like sodium hydrogen carbonate or a combination of aluminium and magnesium hydroxide. Excess hydrogen carbonate might turn the stomach alkaline, triggering the creation of even more acid. These metal hydroxides are insoluble, they do not raise the pH over neutrality, making them a preferable alternative. These treatments merely address the symptoms, not the root of the problem. As a result, the patients cannot be easily treated with these metal salts.

Keyterms: Antacids, Drug, Stomach acids, Calcium, Sodium bicarbonate, Aluminium, Magnesium, Magnesium hydroxide, Hydrogen carbonate, Hydrogen, Metal hydroxides

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Antacids - How does it Work?

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Antacids are a class of medications that are used to treat problems caused by the stomach's acid production. Hydrochloric acid, which is produced naturally in the stomach, aids in the breakdown of proteins. When the acid secretion is active, this acid causes the contents of the stomach to be acidic in nature, with a pH level of 2 or 3. (pH levels are a measure of stomach acidity; the lower the number, the more acidic the stomach.) Several protective mechanisms protect the stomach, duodenum, and oesophagus against acid.

When there is too much acid or the protective mechanisms are insufficient, the acid can harm the lining of the stomach, duodenum, or oesophagus, resulting in inflammation and ulcerations, as well as a variety of gastrointestinal symptoms such as:

• Nausea
• Abdominal pain
• Heartburn

Antacids are OTC drugs that help to neutralize stomach acid.

They differ from other acid reducers like H₂ receptor blockers and proton pump inhibitors in how they act (PPIs). These medications act by lowering or inhibiting stomach acid output.

Symptoms where Antacids can be used

Antacids can be used to treat a variety of symptoms caused by too much stomach acid, including:

• Regurgitation
• Bitter taste
• Persistent dry cough
• Pain while lying down
• Difficulty swallowing are all the symptoms of acid reflux. 
• Heartburn is a burning sensation in your chest or throat caused by acid reflux.
• Abdominal pain (also known as the sour stomach)
• nausea can be caused by a variety of illnesses, including inflammation or acid-peptic ulcers of the oesophagus (esophagitis), stomach (gastritis), or duodenum (duodenitis) (duodenitis)

Indigestion is a pain in your upper intestines that feels like gas or bloating.

When a person is diagnosed with GERD, doctors usually urge them to make dietary and lifestyle adjustments. Doctors may also give H₂ receptor blockers and proton pump inhibitors in addition to antacids.

H₂ Receptor Blockers include the following:

• Nizatidine (Axid)
• Cimetidine (Tagamet HB and Tagamet)
• Famotidine (Pepcid AC and Pepcid)

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Types of Antacids

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Aluminium Carbonate Antacids

Aluminium carbonate antacids bind phosphate in the intestine and prevent it from being absorbed into the body, they can be used to treat and manage hyperphosphatemia (abnormally elevated levels of phosphate in the blood). Aluminium carbonate antacids can also be used in conjunction with a low-phosphate diet to prevent the production of kidney stones, as kidney stones are made up of different elements, including phosphates, due to their capacity to bind phosphate in the intestine.

Calcium Carbonate Antacids 

Some calcium is absorbed into the body, calcium carbonate antacids are utilised in cases of calcium insufficiency, such as postmenopausal osteoporosis.

Magnesium Oxide Antacids 

Magnesium oxide antacids are used to treat magnesium deficiency caused by a lack of magnesium in the diet or by drugs that deplete magnesium levels.

Preventing bleeding from stress-induced ulcers is one of the off-label (non-FDA-approved) uses for antacids containing aluminium and magnesium or aluminium alone. Therapy and maintenance of duodenal ulcer healing and treatment of stomach ulcers are two further off-label uses for antacids.

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Side Effects of Antacids

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• Antacids can cause milk-alkali syndrome and dose-dependent rebound hyperacidity.
• Aluminium hydroxide-containing antacids can cause constipation, aluminium poisoning, osteomalacia, and hypophosphatemia.
• Magnesium-containing antacids have a laxative action that can cause diarrhoea, and they can raise magnesium levels in the blood in individuals with renal failure due to the kidneys' impaired ability to clear magnesium from the body through urine.

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Precautions to be Taken while Antacid Intake

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• Acid rebound can occur when antacids (such as calcium carbonate) are taken in large quantities and for long periods of time. Acid rebound is a syndrome that occurs when the stomach produces even more acid after eating or drinking. The effects of acid rebound, fortunately, are not clinically significant.
• The milk-alkali syndrome can be caused by a combination of high-dose calcium carbonate and sodium bicarbonate. It causes headaches, nausea, irritability, and weakness, as well as hypercalcemia (high blood calcium levels) and kidney dysfunction.
• Excessive use of aluminium-containing antacids can produce hypophosphatemia (low blood phosphate levels), which can lead to muscle weakness, anorexia, and osteomalacia in extreme cases (softening of the bones due to defective bone mineralization).
• In individuals who have recently experienced substantial upper gastrointestinal bleeding, antacids containing aluminium hydroxide should be administered with caution.
• It's critical to pay attention to the sodium level in sodium-based antacid preparations like sodium bicarbonate for individuals with illnesses including high blood pressure, chronic heart failure, renal failure, and those on sodium or salt-restricted diets.

Read More: Carboxylic Acids

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Things to Remember

• Antacids are a type of medication that aids in the neutralisation of stomach acids. Calcium, sodium bicarbonate, aluminium, and magnesium are among the ingredients in these tablets, which act as alkalis or bases in the stomach, neutralising the pH.
• When a person is diagnosed with GERD, doctors typically advise them to change their diet and lifestyle. In addition to antacids, doctors may prescribe H2 receptor blockers and proton pump inhibitors.
• All antacid tablets are capable of acting in two ways.

1. Antacids form a protective layer on the oesophagus's surface to protect it from stomach acids.
2. They secrete a gel on the stomach's surface that helps to prevent acid leaks into the food pipe. In this method, heartburn symptoms can be avoided.

• When stomach contents reach the oesophagus, acid reflux occurs. It's also known as acid regurgitation or gastroesophageal reflux. If you have acid reflux symptoms more than twice a week, you could be suffering from GERD. Furthermore, GERD can cause trouble swallowing as well as respiratory problems such as asthma.

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