Medicines and products for reflux disease

Medicines are used when lifestyle changes are not enough or when reflux is frequent. The right choice depends on the severity of symptoms, other health conditions and any damage seen on endoscopy. Always use medicines under medical guidance, particularly for long-term treatment.

Antacids and alginates Antacids containing calcium carbonate, magnesium or aluminium neutralise acid for a short time. Alginate products form a protective layer on stomach contents. They suit occasional symptoms and should not be a long-term substitute for treatment.

H2 blockers Famotidine and similar medicines reduce acid production for several hours. They are useful for night symptoms and milder reflux. Ranitidine has been withdrawn in many countries, so ask your doctor or pharmacist about current options.

Proton pump inhibitors (PPIs) Omeprazole, pantoprazole, esomeprazole, rabeprazole and lansoprazole are the most effective acid-reducing medicines. They are usually taken 30 to 60 minutes before the first meal for a set course, often 4 to 8 weeks. Long-term use needs review because of possible effects on vitamin B12, magnesium and bone health, and an increased risk of some infections.

Prokinetics Medicines such as domperidone or itopride may help the stomach empty faster in some people, but they have side effects and need a prescription.

Surgery and procedures Anti-reflux surgery (fundoplication) or newer procedures are considered for people who do not respond to medicine or who cannot take it long term.

Medicines that can worsen reflux Anti-inflammatory painkillers, some blood pressure and asthma medicines, and sedatives. Never stop a prescribed medicine on your own.

Ayurvedic view (interpretive) Traditional formulations are sometimes used for acidity, but evidence is limited. Check with your doctor before combining them with prescription medicine.

Remember Do not take acid-reducing medicines daily for months without medical advice, and see a doctor for alarm symptoms.