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How to Choose the Right Acid Reflux Medication

March 13, 2024

Acid reflux affects just about everyone. And when it strikes, your first instinct may be to reach for an antacid like Tums.

But are antacids the right choice for acid reflux?

We asked an expert what you need to know before choosing an acid reflux medication.

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If you experience occasional acid reflux, antacids may be for you.

If you have mild acid reflux pretty infrequently, antacids can be the right choice says Gena Cobrin, MD, gastroenterologist with Hartford HealthCare’s Digestive Health Institute.

“Antacids provide immediate, temporary relief when you are already experiencing acid reflux,” she notes. “But they don’t prevent it.”

These can be purchased over-the-counter and include Tums, Rolaids, Mylanta and Alka-Seltzer.

Lifestyle changes can also help with acid reflux.

The good news, says Dr. Cobrin, is that there are many ways to improve acid reflux. Try making some simple lifestyle changes, like:

  1. Avoiding trigger foods like caffeine, alcohol, chocolate and tomato-based products, fatty or fried foods
  2. Adding more fiber to your diet
  3. Avoiding large meals or eating too late at night
  4. Losing weight
  5. Sleeping on your left side or on an incline
  6. Wearing loose fitting clothing
  7. Standing straight or improving posture
  8. Quitting smoking

“If you have frequent symptoms after making lifestyle changes or despite taking antacids, you have some options available,” Dr. Cobrin says.

> Related: 4 Home Remedies for Heartburn That Actually Work

3 more types of acid reflux medication.

Besides antacids, there are other types of acid reflux medication. Some are available over the counter and others by prescription. These include:

  • H2RAs (histamine 2 receptor antagonists) reduce the amount of acid produced in your stomach. These don’t provide immediate relief, but work over time and provide longer-lasting relief than antacids. Examples include Pepcid AC or Zantac 360
  • PPIs (proton pump inhibitors) also reduce the acid in your stomach, but in a different way than H2RAs. They work by stopping proton pumps in your stomach from releasing acid and provide longer relief than H2RAs. Examples include Prilosec, Nexium or Prevacid.
  • PCABs (potassium-competitive acid blockers) also target proton pumps, but bind to them instead of blocking them like PPIs. This makes the effects more easily reversed. They are a newer form of acid reflux medication and offer an alternative for people who don’t respond well to other medications.

The best medication for you depends on your symptoms.

Acid reflux medication isn’t one-size-fits-all. But a doctor can help you decide what medication is right for you.

“Your course of treatment will depend on your symptoms,” says Dr. Cobrin. “In patients with mild or occasional symptoms, we often recommend step-up therapy. This means you would start with antacids, then move up to H2RAs, and eventually to PPIs.”

But if your symptoms are more severe?

“In that case, we recommend step-down therapy, meaning you start with a PPI and work the other direction,” she says.

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Persistent acid reflux can be sign of something more serious.

If your acid reflux is that persistent, treating it yourself likely isn’t the best option.

“Frequent, severe acid reflux can be a sign of something more serious,” says Dr. Cobrin. “It’s important to keep your doctor informed, and find the treatment plan that’s right for your specific symptoms.

And if your doctor suspects that something more serious is going on, they might recommend an endoscopy.

“Patients with worsening symptoms, erosive esophagitis, or Barrett’s esophagus need to be on medications. If you have concerns, speak to your doctor right away and find a treatment plan that works for you.”