Acid Reflux by Cynthia Jean, PharmD

What is acid reflux? Why am I experiencing it? How can I alleviate it?

Digestion involves more than just chewing and swallowing your favorite meal. For our stomachs to digest the foods we eat, it uses acid to further break down what we ingest.  Normally, there’s a pressure valve that prevents the acid in the stomach from flowing up into our esophagus.  When that pressure valve malfunctions, the acid goes where it does not belong, and acid reflux occurs.  Acid reflux may cause different symptoms in different people.   Some may experience any of the following:

  • A burning sensation in the chest (heartburn)
  • A burning sensation in the throat or acidic taste in their mouth
  • Stomach or chest pain
  • Nausea or vomiting
  • A raspy voice or sore throat
  • Cough

There are different ways to alleviate the cause and symptoms of acid reflux and they fall into two categories: 1. Life Style Modifications 2. Medication.

Life style modifications are minor changes in daily life that can be made to improve symptoms.  The following are modifications that can be made to decrease acid reflux:

  • Avoid lying down within 3 hrs of eating
  • Avoid eating within 3 hrs of going to bed
  • Avoid tight fitting clothing
  • Avoid foods that can make your acid reflux symptoms worse.  These include: spicy foods, coffee, cola, tomato sauce, citrus fruits, chocolate, and fried foods.
  • Avoid eating large meals. Instead eat smaller meals throughout the day.

If the lifestyle modifications mentioned above do not alleviate your acid reflux symptoms, the next step would be to consult with your doctor to see what medication would be best for you. These medications can be purchased over-the-counter or with a prescription. The commonly used medications for acid reflux fall into two categories:

  1. Histamine 2 Receptor Antagonist (H2RA) - Zantac®(ranitidine), Pepcid (famotidine)®, Tagament®(cimetidine), and Axid®(nizatidine).
  2. Proton Pump Inhibitors (PPI) - Prilosec®(omeprazole), Nexium®(esomeprazole), Protonix®(pantoprazole), and Aciphex® (rabeprazole).

If your acid reflux symptoms are not extremely severe, your prescriber may opt to prescribe H2RA medication for you. If that does not help, the prescriber may ‘Step Up’ your treatment by prescribing a PPI instead.

If your acid reflux symptoms are more serious, your prescriber may opt to immediately start you off with a PPI medication, and then switch you to an H2RA if tolerated.  This is known as ‘Step Down’ therapy.   The goal of each treatment option is to use the best medication to address your acid reflux signs and symptoms. Have a conversation with your physician to discuss the best acid reflux control plan for you. 

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