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Antacids

Anna Walner, Kristina Matisic

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What to Look For

Antacids are the most common remedy for combating heartburn but there are also the newer H2 Blockers available in different strengths on the market. While they work differently, the result is the same - no painful heartburn.

Antacids
Antacids are medicines that neutralize stomach acid commonly associated with acid indigestion, upset stomach, sour stomach and heartburn. Some antacids also help relieve gas.

Main active ingredients will differ slightly between brands but most antacids will include one or more of the following ingredients:

Sodium Bicarbonate
Magnesium (Hydroxide)
Calcium (Carbonate)
Aluminum (Hydroxide)
Alginic acid/Alginates
Simethicone
Bismuth

There are several antacids available including: Rolaids, Tums, Diovol, Gaviscon and Maalox.

H2 Blockers
While antacids work to neutralize the acid already produced in the stomach, H2 Blockers work to decrease stomach acid secretion thus preventing heartburn from occurring in the first place. They don’t act as quickly as antacids, but they provide longer relief. You should take these medications before a meal you think may cause heartburn, because it takes them about 30 minutes to an hour for them to work.

H2 blockers are available in both over the counter and prescription forms; for example, Pepcid® (famotidine), Tagamet® (cimetidine), Zantac® (ranitidine), and Axid® (nizatidine) are all over-the-counter H2 Blockers which are also available by prescription at higher doses.

H2 blockers have not been studied on women during pregnancy. However, side effects are unusual for this medication, except among elderly patients. When they do occur, they may include mild diarrhea, constipation, dry skin, rash, runny nose, headache, and dizziness.

What's Out There Many people who suffer from occasional heartburn take antacids either in tablet or liquid form, which are readily available at the drugstore. Some antacid preparations relieve symptoms by forming a layer on top of the stomach contents. If you find that you have to take these medicines regularly or you don’t get any relief, it is best to visit your doctor. He or she can decide if tests are needed to find the cause of the problem. Your doctor can also prescribe stronger medicine that will reduce or prevent the production of acid in the stomach and allow the inflamed esophagus to heal.

Our Tests Just so we could visually see how antacids work, we tested five antacids by adding them to hydrochloric acid (which is what stomach acid is ) and purple cabbage juice. Here’s how it works. When you mix the hydrochloric acid with the cabbage juice, it turns a reddish colour. Once you add the antacid, it’s supposed to turn back to purple. We timed how long it took each antacid to take effect.

Antacid	Time to Neutralize Acid
Rolaids	25 seconds
Tums	30 seconds
Diovol Plus	8 minutes
Gaviscon	20+ minutes
Maalox Extra Strength	20+ minutes

Neutralizing the stomach acid quickly isn’t always the most important thing. Some of the ingredients in these products are also designed to coat your esophagus, soothing any pain localized there. Then it will go on to attack the stomach acids which are causing your discomfort.

Now to the real test - we enlisted heartburn sufferers to test our five antacids. When they felt the ‘burn’ they experimented with each of the products keeping track of the results.

Antacid	Type	Ingredients	Cost/Dose
Rolaids	tablet	Calcium carbonate (550 mg); Magnesium hydroxide (110 mg)	3¢
Tums	tablet	Calcium (500 mg)	10¢?
Diovol Plus	tablet	Magnesium (100 mg); Aluminum hydroxide & magnesium carbonate (300 mg); Simethicone (25 mg)	36¢
Gaviscon	tablet	Alginic acid (313 mg); Magnesium carbonate (63 mg)	24¢
Maalox Extra Strength	Liquid	Magnesium hydroxide (400 mg); aluminum hydroxide dried gel (400mg); simethicone (40mg)	26¢

For mild heartburn the Tums were the favourite. They’re convenient and taste good too. Medium strength heartburn sufferers found the Diovol Plus to work really well. Our more severe sufferers went with liquid Maalox. The aluminum hydroxide content in Maalox can provide longer lasting relief. Based on our results we think if you have the odd bout with heartburn try Tums, they work. If your heartburn is stronger go for Maalox it definitely made a difference.But note that antacid preferences are very subjective and individualized, so test your options.

Anna and Kristina aren’t prone to heartburn but they were curious about how the antacids tasted – always an important consideration! They tasted each of the heartburn remedies, some were better than others, some tasted just plain yucky. The best tasting according to The Shopping Bags were the Tums, second place going to Maalox. After You Buy

General Precautions and Side Effects for Antacids

are meant to be used only occasionally
side effects are very rare when antacids are taken as directed and are more likely when the antacids are taken in large does or over a long period of time
minor side effects can include: chalky taste, mild constipation or diarrhea, thirst, stomach cramps, and whitish or speckled stools
constipation can often be caused by calcium; look for antacids that contain magnesium which will work to counteract adverse effects of calcium
calcium-based antacids work quick, but over the long-term the calcium can actually stimulate stomach acid which causes the heartburn in the first place
should not be taken continuously for more than two weeks unless under a physician’s directions
taking antacids over long periods could mask the symptoms of a serious stomach or intestinal problem, such as peptic ulcer disease
many antacids contain lots of salt, which can elevate blood pressure
older people should be especially careful, as they may have ulcers without showing the typical symptoms
anyone who is taking any prescription drug should check with the prescribing physician before taking antacids
antacids may affect the results of some medical tests; if scheduled for a test, ask if you can take antacids before
should not be given to children under age 6 years unless directed by their physician
pregnant women should check with physicians before using antacids; occasional use in small amounts is considered safe
some antacids may pass into breast milk: but there’s no evidence that it causes any problems for nursing babies if only occasional use

The most important and helpful aspects of treatment are those which you can do for yourself:

Stop Smoking
After a meal, when the stomach is full, smoking increases the chances that you will suffer from heartburn.

Avoid becoming overweight
For many patients weight reduction is the most important remedy. Excess weight will put extra pressure on stomach and diaphragm which will contribute to heartburn.

Diet
You may find particular foods can make your symptoms worse. These might include: acidic fruit drinks, drinks which are too hot, alcohol, caffeinated or carbonated beverages, chocolate, garlic, onions, peppermint, or fatty and spicy meals. It is better to eat ‘little and often’ and to fill but do not over-fill the stomach. Food should be eaten slowly and chewed well.

Sleeping
Let your evening meal digest well before you go to bed. Night-time symptoms can also be reduced by keeping your head raised 6 inches off the bed (lots of pillows!) Gravity helps to keep the acid in the stomach where it belongs. Some people also find relief by sleeping on their left side.

Posture
Avoid bending from the waist or stooping just after meals. Instead, try and bend from the knees, keeping the back straight. It’s better to eat while sitting upright in a chair rather than slumped in front of the television.

Clothing
Avoid tight belts and underclothes as they increase pressure on the stomach.

Pregnancy It is common for pregnant women to suffer from heartburn. By eating sensibly and keeping your weight increase within the recommended limits, you can lessen the severity of heartburn.

Thanks To Our Experts…
Dr. Robert Enns Gastroenterologist describes exactly what goes on inside the body when heartburn hits.

Heartburn has nothing to do with the heart - it is a digestive problem. It’s a discomfort or pain caused by the stomach regurgitating acids up into the esophagus. The esophagus is not made to withstand acids and is thus irritated and inflamed when acid from the stomach refluxes into it. The pain can be felt behind the breastbone, often described as a ‘burning’ sensation. Pain can also be felt at the same level in the mid-line of the back. Most people suffer from heartburn at one time or another, but some experience it more often and to a greater degree. It is generally related to meals and posture and can often be relieved by remedies for indigestion – namely, antacids. Which one works the quickest and most effectively? We’ll test some popular brands, letting antacid sufferers decide.