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Long term use of anti-acids

  1. Sep 22, 2015 #1
    First - I'm not medically trained - this question comes about because of a relative being prescribed these.
    As I understand it ant-acid drugs neutralize the natural acids in the stomach the body makes naturally
    in order to digest food.

    Given my limited knowledge of basic chemistry I can see how too much acid could "damage" a stomach
    and cause discomfort and neutralising it provide relief.

    However there seems to be no scientific testing in the long term prescription (over many years) for
    these drugs or indeed any testing to see if acid reduction is required. GP's arer told by the
    patient that they have stomach ache and are put on these drugs on that basis - perhaps for many years.

    Is there some reason that the body doesn't care or that an abitrary use of anti acid drugs doesn't
    matter to the body or the digestive system.
    I'm just a bit curious about this.
     
  2. jcsd
  3. Sep 22, 2015 #2
    I think the idea is reduce the amount of acid when it's presence it's thought to be in higher concentration than necessary.
    Not to eliminate it entirely, just to bring it down to level where it can't be a cause of other digestion problems.
    I think the active ingredient is just chalk or something similar which is harmless.
     
    Last edited: Sep 22, 2015
  4. Sep 22, 2015 #3
    Careful when you say harmless, nothing is harmless if the amount is great enough. Swallow an entire box of Tums and you might have a problem.
     
  5. Sep 22, 2015 #4
    You state that the patient was prescibed "anti-acid" drugs, but not really what type.
    Anti acid refers to the type of compound that one can buy at any drug store for symptoms for what is commonly known as heartburn, and a lot of times self medication would be the norm for acute symtoms rather than chronic.
    Other pills that a doctor could prescribe to 'control' stomach acid, can considered to modify the acid production of the stomach.

    Long term use of either the anti-acid or the acid production inhibitors does have its problems, which includes absorption of nutrients, and not the least of which is an interaction with other drugs. There is some knowledge on long term usage.

    You can start with
    https://en.m.wikipedia.org/wiki/Antacid
    and follow the two links to inhibitors.

    I have no idea why some people have an active acid producing stomach versus others.

    Years ago, my sistor, passed along from her nursing training, that something as simple as the alkaline pills such as Tums should not be taken every day.
     
  6. Sep 22, 2015 #5

    berkeman

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    Then it is most appropriate for your relative to discuss this with the prescribing physician.
     
  7. Sep 22, 2015 #6

    Choppy

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    It looks like 256bits beat me to the reply here, but I think that by the a patient comes to a physician with a stomach-acid related problem, such as GERD, they will usually look to a type of drug called a proton-pump inhibitor, which inhibits the production of stomach acid rather than simply taking some kind of over-the counter buffer.


    On what basis hvae you concluded there is no long term scientific testing? Proton pump inhibitors have been extensively studied and continue to be.
    See for example these review articles:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874135/
    http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2005.02611.x/full

    While no drug is completely free of side-effects, PPI's are generally considered fairly safe in terms of a low risk for complications.
     
  8. Sep 23, 2015 #7
    I think some confusion over time is leaking in - sorry if I wasnt plain enough -
    By long term testing I'm not talking about drug manufacture.

    My curiosity is in the way GP's prescribe without any form of test and then keep on prescribing for years afterwards
    without any other intervention.
    I was also wondering
    a) If long term deliberate arbitrary chemical modification had any biological effects in the long term (I find it odd that it wouldn't)
    b) Why no testing prior to prescribing is done (or after) to see if acid this is a cause or effect - it just seems like something that should be tested
    especially if the plan is life-long prescribing of drugs
    c) What test can they do to see if a complaint is actually an acid related problem - my relative wasn't tested at all (hence a/b)
    (I don't know if a test is even possible - I'm just asking)
     
  9. Sep 23, 2015 #8

    Choppy

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    I'm not sure I understand the question, still, then.

    How do you know that physicians prescribe these medications without any tests? When a patient comes in complaining of a chronic stomach-acid condition, physicians will often do a lot of testing to rule out other more concerning conditions. Often the initial complaint can be "chest pain" which can trigger a battery of tests including and ECG and bloodwork to make sure that it's not an immediate life threatening condition. From there they tend to work their way down the list. Patients with stomach problems will often be sent for an endoscopic examiniation where the esophaus will be examined for chronic inflamation or Barret's esophagus or worse conditions like esophageal cancer, for example.


    Any medication is going to have some kind of side-effects. With drugs such as the PPI's I mentioned, there were concerns about the body's ability to absorb certain vitamins (B12 I think was a specific one). There were also concerns about such drugs might affect mineral absorption and some studies have looked at bone density or fractures in users vs non-users.

    But the think with medical treatments is that physicians are always weighing the benefit of a given drug or therapy agaisnt the risks involved.

    Largely, according the review articles, the issues I mentions appear not to be significant enough to warrant discontinuance of the drug in the majority of cases and long-term use of those drugs are considered safe, in general. There may be specific situations - patients with specific conditions - where a different treatment may need to be explored.

    Something else to keep in mind is that in some cases physicians can use a "READY FIRE AIM" approach to medicine. Once more severe conditions have been ruled out, you can reach a point where you prescribe a medication and then observe the consequences without making an official diagnosis.

    This is done in situations where the side-effects of a medication on a healthy person are minimal. If the drug works - great. The problem is solved. If not - you investigate further. In over-burdoned healthcare systems this approach allows more patients to be seen and effectively treated and allows the physicians to spend more time investigating the problematic cases.


    Hopefully my response above makes this a little more understandable. Ultimately though, if you're relative is not happy with, or does not understand the decision to go onto a specific medication, that's a question for that person to discuss with his or her doctor.
     
  10. Sep 25, 2015 #9
    People often get stomach irritation which may be due to excess acid or inflammation of the stomach lining so that normal acid levels become irritant, most antacids used contain something to reduce and buffer the acid and something to help protect the stomach lining like a gel. Simple base solutions like Sodium Bicarbonate often work very quickly but can cause the stomach to produce even more acid. All these do is provide relief of symptoms and occasional use seems pretty safe. If there is something more serious causing these symptoms its unlikely that these drugs would provide adequate long term relief and repeated visits to a doctor would lead to increasing investigations. Rather surprisingly many problems associated with hyper acidity can be attributed to either taking certain drugs like aspirin or with a chronic infection in the stomach. These things are generally easy to diagnose, though they normally want to have a look in the stomach initially to be sure, the older the person is the more likely they will be to investigate. Remember the clinical interview is an investigation, acid problems often have characteristic ways of presenting and the doctor will generally have a good idea about the cause, they will only do further investigations if they feel its necessary. These other causes normally need to be managed with things other than simple antacids.
     
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