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How to Manage Acid Reflux

Edited by Olivia McPherson


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What is acid reflux?


Acid reflux is a common issue that some of us will experience at some point. It is also referred to as GERD (gastro-esophageal reflux disease), with heartburn being the most common symptom. People will often describe it as a burning sensation in the throat or chest and may also report a sour taste in their mouth. Acid reflux occurs due to stomach acid washing out of the stomach and back up into the esophagus. Not only is acid reflux unpleasant to deal with, but if left unmanaged for too long, it can lead to complications such as stomach ulcers, bleeding, and inflammation.



What causes acid reflux?


Acid reflux can be a result of both lifestyle factors and medical conditions. Some lifestyle factors that can contribute to acid reflux include certain foods and beverages such as chocolate, coffee, peppermint and alcohol, smoking cigarettes, and a higher BMI (body mass index). Some medical conditions that could be causing acid reflux include hiatus hernia, irritable bowel syndrome, anxiety, and H. Pylori infection, among others. If your acid reflux symptoms do not seem to be linked to a specific lifestyle factor or if they persist for longer than two weeks, you should seek assessment by a medical professional.



What can I do to help manage acid reflux?


Ways that you can manage acid reflux symptoms at home include eating smaller meals and avoiding foods that may trigger or worsen reflux such as fast food, spicy foods, alcohol and coffee, avoiding eating too close to bedtime, and avoiding tight fitting clothes around the abdomen and chest that may put pressure on your stomach. If you are experiencing acid reflux primarily at nighttime, you can raise the head of your bed with blocks or bed risers to decrease occurrence of nighttime reflux.


If the above options are insufficient to control your symptoms, there are many medications that can help block or reduce the acid in your stomach. Some are available over the counter at your local pharmacies, while others will require a prescription from a healthcare provider. The types of medications that are commonly used are antacids, histamine blockers, and proton pump inhibitors.


Antacids work by neutralizing the acid in your stomach. They work quickly after being taken, but only provide short-term relief. They are intended to be used when reflux is mild and occasional. Examples of antacids include TUMS, Rolaids, and Gaviscon which are available over the counter without a prescription.


Histamine blockers work by preventing histamine from binding to receptors on the stomach. Histamine stimulates cells that secrete stomach acid, so by blocking histamine, this reduces the amount of acid produced. They have a stronger effect than antacids and last longer, making them suitable for long-term treatment of reflux. Pepcid (Famotidine) is an example of a histamine blocker that is available without a prescription. Other histamine blockers will require a prescription.


Proton pump inhibitors (PPIs) is the strongest class of medications used to treat acid reflux. Like histamine blockers, they bind to receptors in the stomach to prevent the production of stomach acid. However, PPIs bind more tightly to their receptors than histamine blockers do, making them the strongest and most suitable for long-term treatment of acid reflux. Nexium (Esomeprazole) is a PPI that is available over the counter, while others require a prescription.


*Fun Fact: Did you know that pharmacists in most provinces are now able to prescribe medications for acid reflux?



When should I go to the doctor?


Even with lifestyle and medication management, there are some cases where acid reflux cannot be managed. If your symptoms are severe, long-lasting, or uncontrollable, then seeing a doctor is recommended. Other indicators to see your doctor include chest pain, blood in your stool or vomit, sudden weight loss, and difficulty swallowing food.


Acid reflux is a common symptom that can be bothersome but is usually manageable with lifestyle changes and medications. Medications that are used to treat acid reflux can be purchased over the counter or by prescription. If you have any questions regarding lifestyle or medication management of acid reflux, you can always reach out to your local community pharmacist.



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References

  1. Acid Reflux and Gastroesophageal Reflux Disease in Adults. In: Lexicomp. Lexicomp. Updated November 28, 2022. Accessed December 11, 2022. https://www.online.lexi.com/

  2. GERD - What you need to know. In: Compendium and Pharmaceuticals and Specialties. Canadian Pharmacists Association. Updated December 6, 2022. Accessed December 11, 2022. https://www.myrxtx.ca/

  3. Pham, Q.D. Dyspepsia and GERD. In: Compendium of Therapeutics Choices. Canadian Pharmacists Association. Updated November 24, 2022. Accessed December 12, 2022. https://www.myrxtx.ca/

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