Monday, May 29

These are the dangers of abusing antacids

Heartburn is one of the most common digestive problems in Spain. It occurs in 30% of Spaniards at least once a week, according to data from the Spanish Federation of the Digestive System (FEAD), which clarifies that when this discomfort is suffered more than two days a week, it should be considered a symptom of Gastroesophageal Reflux Disease (GERD).

When heartburn is punctual, it may be the result of eating too much or eating too fast. But it can also be due to other causes such as stress or unhealthy lifestyle habits, such as tobacco, alcohol consumption or obesity.

What are antacids

Antacids offer a quick response to copious meals and heavy digestions, when a burning sensation appears in the pit of the stomach and chest. In addition, they can be obtained without a prescription, which makes it much easier to have them available at any time.

Antacids raise the pH of the stomach to neutralize it, leading to rapid relief from heartburn. The molecules, when coming into contact with hydrochloric acid, transform them into a new non-acid chemical compound, in most cases into salt and water.

The important thing about these products is their active ingredients. There are them with bicarbonate and salts; almalgate and magaldrate; pantoprazole; antiflatulents; magnesium and aluminum; H2 antagonists. All of them alkalize the gastric pH in a particular way.

But can we take them every day? Can side effects appear?

The consumption of antacids in Spain

The Spanish Agency for Medicines and Health Products (AEMPS) published in 2014 a report on the evolution of antacid consumption in Spain between 2000 and 2012which revealed a significant increase from 33.3 doses per 1,000 inhabitants per day in the year 2000 to 136.8 in 2012, which is equivalent to an increase of 310.4%.

The same document revealed a significant increase, especially in the consumption of proton pump inhibitors (PPIs), among which Omeprazole stands out. In twelve years, it went from 20 daily doses per 1,000 inhabitants to more than 100 daily doses per 1,000 inhabitants, that is, consumption increased fivefold (up 500%).

There are no official data after this date, but in 2022 the Spanish Society of Physicians Specialized in Primary Care (SEMERGEN) continued to warn of the dangers of abuse, especially in even unnecessary cases, such as taking Omeprazole in the false belief that it can help prevent hangovers.

The effects of misusing antacids

The effectiveness of antacids is key when taken in specific cases (less than four times a month). They are fast-acting (they usually act in less than 15 minutes), but temporary (they last less than an hour).

Many of the side effects of antacids come from not taking them as directed on the package insert. The correct way to use them is to do it only occasionally, for specific causes and in the recommended doses.

If not, it increases the possibility of problems such as the following listed in the SEMERGEN in this document:

  • Diarrhea: Magnesium-containing antacids work quickly. It is, after calcium carbonate, the antacid with the highest acid neutralizing power. But its excessive use can cause diarrhea, which is usually mild and ends when the drug is stopped. This occurs because magnesium hydroxide increases the amount of water in the intestines.
  • Constipation: It is one of the most common symptoms of excessive use of antacids, especially calcium and aluminum. This symptom often remains while taking antacids, so it is important to switch to a different medication.
  • Decreased absorption of other drugs: antacids can also interfere with the function of other medications. Therefore, it is important to use them with caution, especially those with chronic conditions such as heart failure, kidney failure, people on low-sodium diets, or hyperparathyroidism. For example, since most contain calcium, this would negate the absorption of an iron supplement. The absorption of certain antibiotics is also reduced. It is advisable to take any other medication once hour before or four hours after to take antacids.
  • Fluid retention: When the antacid is calcium or sodium based, it works by neutralizing stomach acids. But if they are used for a long time, fluid retention increases and blood pressure rises. Therefore, it should be avoided in people with hypertension or heart disease.
  • hypercalcemia: Calcium carbonate is a fast-acting antacid and is the one with the greatest neutralizing power. But taking too many calcium preparations can lead to an ‘overdose’ of calcium, resulting in symptoms such as nausea, vomiting and kidney stones.
  • aluminum buildup: People with kidney disease should avoid taking antacids, especially those that contain aluminium, because their impaired kidney function can lead to the accumulation of a toxic level of aluminum in the bloodstream.
  • more acidity: Excessive consumption of antacids for a long period of time increases the risk that we will get just the rebound effect: more heartburn. As we already explained in this article, in excessive amounts of sodium bicarbonate, the stomach produces a greater amount of acid to compensate for what has been neutralized by the basic substance. This will lead us to take more bicarbonate which, in turn, will cause the stomach to produce more acid.
  • Higher incidence of infections Clostridium difficile: a study reveals a higher rate of infections among hospitalized patients when Omeprazole is administered constantly and regularly.

Taking antacids when suffering from heartburn is not counterproductive, but they should only be a temporary solution because they are not intended for continued daily use. It should be noted that we do not get more efficiency even if we take more than indicated.

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