One of the ways to treat gastroesophageal reflux is to decrease the acid content of the stomach so that it does not hit the esophagus. So, if the reflux is less acid it will burn less and cause fewer symptoms.
The medicines that can be used are antacids, acid production inhibitors, stomach protectors and gastric emptying accelerators.
1. Antacids
The antacids most used to neutralize stomach acid are hydroxide, 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 so often because they are not as effective 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 antacids that contain magnesium, as they cause an osmotic effect in the intestine. To minimize these side effects, the most commonly used antacids are combinations of magnesium hydroxide and aluminum.
2. Inhibitors of acid production
Inhibitors of acid production are the most commonly used drugs in the treatment of gastroesophageal reflux, which can inhibit this production in two ways:
Proton Pump Inhibitors
These are the main remedies used in the treatment of diseases related to the increase of gastric acid secretion. The most commonly 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 medicines are headache, diarrhea, rashes, abdominal pain, flatulence, nausea and constipation.
Histamine H2 receptor antagonists
These drugs inhibit acid secretion induced by histamine and gastrin and the most commonly used are cimetidine, ranitidine, nizatidine and famotidine.
The most common side effects caused by the use of these medicines are diarrhea, headache, drowsiness, tiredness, muscle pain and constipation.
3. Gastric emptying accelerators
When the stomach is too full, there are more chances of gastroesophageal reflux. Therefore, to avoid this, gastrointestinal motility can be stimulated with prokinetic drugs such as metoclopramide, domperidone or cisapride which help with gastric emptying, thus decreasing the time the stomach remains in the stomach, avoiding 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 disturbances may occur with the use of domperidone and cisapride.
4. Gastric shields
Gastric shields may also be used to treat gastroesophageal reflux, which protects 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 mucosa of the stomach, preventing the acid from sticking to it, but in some pathological states and with the use of some medicines, the production of this mucus can diminish and provide the aggression of the mucosa. The gastric shields that can be used to replace this mucus are sucralfate and bismuth salts that potentiate the defense mechanisms of the stomach and form a protective barrier in the stomach and esophagus.
The most common adverse effects caused by bismuth salts are dimming of the 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 rashes.
There are also home remedies that can contribute to the success of the treatment. Know which ones are most used.
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