Is the Long-Term Use of Antacids Safe?

Over-the-counter antacids are readily available and provide an easy, effective way to calm the symptoms of heartburn or indigestion. But is it safe to routinely take them? Or could frequent use cause more serious health problems?

“No medication, prescription or over-the-counter, is completely risk-free,” says John Dumot, DO, digestive health specialist at University Hospitals. “When used as directed, antacids are usually safe and effective. However, if you’re popping Tums on a daily basis or taking medications like Prilosec or Nexium beyond the recommended 14-day course, there are some potential risks,” he adds.

Antacids May Mask the Real Problem

Frequent heartburn is a symptom of a common disorder called gastroesophageal reflux disease or GERD – a condition in which the valve between the stomach and the lower esophagus (food pipe) malfunctions and allows stomach acid to bubble up into the esophagus. Over time, GERD can damage the lining of the esophagus and lead to more serious health problems, including Barrett’s esophagus, a pre-cancerous condition.

In addition, the classic symptoms of heartburn like chest pain or burning can be warning signs of a heart attack. “Therefore, before you rely on antacids to treat your symptoms, it is very important to be evaluated by a healthcare provider to ensure you don’t have a more serious health condition masking itself as indigestion,” says Dr. Dumot.

Types of Heartburn Medication

Once it’s confirmed that your symptoms are due to heartburn or acid reflux and not something more serious, there are many over-the-counter medications that may provide temporary relief. These include:

• Acid Neutralizers. Medications like Tums and Maalox contain ingredients that neutralize stomach acid on contact. They do not affect the quantity or production of stomach acid and are safe when used as directed for occasional, short-term relief of heartburn symptoms.
• First-Generation Acid Reducers. Medications like Pepcid and Tagamet are known as H2 blockers. Instead of acting as neutralizers, they work by blocking certain chemicals that signal the stomach to produce acid. Although generally safe when used as directed, H2 blockers may interfere with the absorption of certain medications, including blood thinners, antidepressants and blood pressure medicines. These medications are fast-acting when taken before or shortly after symptoms begin. However, they are best taken on an as needed basis because they can lose their effectiveness if taken for a long period of time.
• Proton Pump Inhibitors (PPIs). The strongest of the three types of medications, PPIs like Prilosec, Prevacid, Protonix and Nexium inhibit certain cells from pumping acid into the stomach. Although generally safe and effective, some studies suggest that long-term use may reduce levels of vitamin B12, magnesium and calcium in the body and increase the risk for hip fractures. People taking PPIs for severe heartburn, stomach ulcers or Barrett’s esophagus, should not stop taking the medication unless advised to do so by their doctor. The benefits may outweigh any potential risks of treatment. Stopping suddenly after prolonged use can also have a rebound effect and worsen heartburn symptoms.

Additional complications that may occur with overuse or misuse use of antacid medications include:

• Liver or kidney problems
• Low blood magnesium
• Digestive issues like constipation, diarrhea, nausea, vomiting and stomach cramps

Controlling Heartburn Without Medication

Many people can prevent or manage heartburn symptoms with lifestyle and dietary changes, including:

Avoid or Limit

• Potato chips and other processed snacks
• Fatty meats such as bacon and sausage
• Cheese
• Tomato-based sauces
• Citrus fruits
• Chocolate, peppermint and carbonated beverages

Eat More

• Alkaline foods like bananas, melons and nuts
• Foods with high water content like watermelon, cucumber and lettuce
• High-fiber foods

Additional lifestyle recommendations include:

• Don’t smoke or use any nicotine products
• Maintain a healthy weight
• Eat small, frequent meals instead of large, heavy ones
• Avoid eating for several hours before bedtime

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The experts at University Hospitals Digestive Health Institute provide comprehensive care for a full range of digestive health issues including heartburn, acid reflux and GERD. Services are available at convenient locations across Northeast Ohio.