Acid reflux is a recurrent and chronic disease that does not resolve itself and go away. There isn't a cure, per se, for acid reflux, but long term medical and lifestyle therapy is usually effective. It helps relieve symptoms in most people. Treatment options include lifestyle changes, medications, surgery, or combination of the above. Most doctors start with the least invasive, least expensive options, such as over-the-counter medicines and changing some troublesome lifestyle habits, and they work their way to more intensive treatments, such as prescription medications and surgery. What is the key to relief of the symptoms?

If the physical cause of many of the common symptoms of acid reflux is the stomach acid refluxing into the esophagus from the stomach, then suppressing that acid and keeping it from irritating esophageal tissue is the key in relieving the symptoms and letting the irritated tissue heal.

Which drugs are best for acid reflux and how do they work?

The following drugs offer effective treatment to "some" or "most" people. Keep in mind though, that none of these current drugs used to treat acid reflux actually cures it. They help control symptoms and some also allow the esophagus to heal if there is tissue damage. Even when the drugs relieve symptoms completely, the condition usually recurs within months after drugs are discontinued.

Antacids and a foaming agents

Antacids are great for rapidly relieving heartburn symptoms. They work directly in the stomach to decrease the acidity of the reflux liquid irritating the esophagus. They also help neutralize the area inside the esophagus. When antacids and a foaming agent are combined, they produce a foam barrier in the stomach, which floats over the contents of the stomach, preventing acid from splashing up into the esophagus. They do not heal esophagitis or prevent complications of acid reflux.

What are the side effects of long term use of antacids?

• Diarrhea from some antacids (Milk of Magnesia) and constipation from others (Amphogel, Alternagel). Aluminum and magnesium salts are used together in Mylanta and Maalox to help balance the side effects of diarrhea and constipation
• Constipation can be caused by Calcium carbonate (Tums, Titralac, and Alka-2). These over the counter antacids are also obviously a source of calcium and in rare cases, can lead to too much calcium in the blood, leading to kidney failure
• A change in the way the body breaks down, and uses, calcium
• An increased risk of kidney stones
• A buildup of magnesium in the body can be serious for patients with kidney disease

If antacids are needed for more than three weeks, a doctor should be consulted.

Can they interact with other drugs I might be taking?

They can reduce the absorption of certain drugs (tetracycline, ciprofloxacin (Cipro), propanolol (Inderal), captopril (Capoten), and H2 blockers), so please let your doctor know if you are using antacids (even if you only use them every now and then). It will help to take the other drugs one hour before or three hours after you take the antacid.

H2 blockers

H2 blockers (also called H2 receptor antagonists), help inhibit acid secretion in the stomach (which helps reduce the stomach acid that tends to worsen symptoms). They work in about 30 minutes and last up to eight hours. There are over the counter H2 blockers and prescription H2 blockers. The over the counter version does not relieve symptoms as quickly as antacids, but they last longer. In other words, they may be slow to start, but once they get going, they help your acid reflux for a long time. H2 blockers have been the traditional drug treatment in acid reflux because many of them can be an effective short-term therapy for resistant acid reflux symptoms. In most studies on H2 blockers, where the participants were taking these drugs twice a day, symptoms were eliminated in up to half of the people.

Keep in mind: First thing to do: Visit your doctor. Don't take any medication on your own. You are risking your health, if not your life.