Reflux medication: what works and what to watch for

Heartburn after meals? You're not alone. Reflux medication falls into three main groups that most people use: antacids, H2 blockers, and proton pump inhibitors (PPIs). Antacids like Tums or Maalox neutralize acid fast but wear off quickly. H2 blockers such as famotidine reduce stomach acid for a few hours and help mild cases. PPIs — omeprazole, esomeprazole, lansoprazole — cut acid production more strongly and are the go-to for frequent reflux.

How to choose? Start with your symptoms. For occasional, mild heartburn an antacid or H2 blocker taken when needed often works. If you have daily symptoms or nighttime reflux, a PPI daily for 4-8 weeks usually brings relief. If symptoms return after stopping a PPI, a short restart or a step-down plan with an H2 blocker can help. Always follow package directions and talk to a clinician before long-term PPI use.

Safety, side effects, and interactions

Short-term use of any reflux medication is generally safe. Long-term PPI use can raise risks: low magnesium, reduced B12 absorption, and a small uptick in some infections. H2 blockers are well tolerated but may cause drowsiness in a few people. Antacids with magnesium or aluminum can stress the kidneys if overused. PPIs can interact with drugs like clopidogrel and some antifungals — tell your doctor about all medicines you take.

Practical tips for better control

Small changes matter. Avoid big meals, late-night eating, and trigger foods like coffee, chocolate, and spicy meals. Elevate the head of your bed 6-8 inches to reduce night reflux. Try a PPI 30-60 minutes before breakfast for best effect. If you need an antacid, use it for immediate relief and not as daily control. If over-the-counter meds fail after a few weeks or you notice weight loss, trouble swallowing, or black stools, see a doctor — those can be warning signs.

Pregnant? Talk to your obstetrician. Antacids are usually first-line in pregnancy; some H2 blockers have a safety record, while PPIs are used when needed under medical advice. Children and older adults may need dose adjustments and medical review before starting stronger meds.

Alginate formulations (Gaviscon) create a foam barrier that stops acid coming up - useful at night or after meals. Over-the-counter PPIs like omeprazole are usually sold as 20 mg and meant for 2-8 week courses; do not double doses without medical advice. Your doctor may order tests like an endoscopy or pH monitoring if symptoms are severe, ongoing, or you have alarm signs. Don't ignore persistent hoarseness, chronic cough, or chest pain — get checked.

If cost or access is an issue, look for generic PPIs; they work the same and are cheaper. Keep a simple symptom diary: note food, timing, and which meds help. That helps your clinician pick the right plan fast today.