Indigestion (also referred to as acidity) is one of the most common ailments that affilicts adults. It is characterized by the presence of excessive hydrochloric acid in the stomach. In some cases, the acid from the stomach may enter the esophagus and cause pain. This pain is frequently referred to as “heartburn”.
The treatment of choice for indigestion or excessive acid in the stomach is usually popping some kind of antacid medication. Antacids refer to a class of drugs that work to neutralize the excess acid in the stomach. They are one of the most used over-the-counter medications along with cold and pain medications. Due to the easy and unrestricted access to antacids, an overuse of antacids can occur in some cases. Such antacid overuse can result in side-effects such as digestive problems.
How safe are antacids?
The easy and unrestricted availability of antacids as over-the-counter medications may give the impression that antacids are very safe medicines. It is true that antacids are generally safe to use in the short term and in the appropriate dosage. However, no medication is without side-effects, especially when used improperly and in the wrong dosage.
Chronic use of antacids can also produce signs and symptoms of antacid overuse. Some of the side-effects of antacid overuse may be restricted to the digestive system. However, the side effects may also extend to other tissues and organs in the body. Therefore, one should always be careful when taking medications for a long period of time. Consulting a doctor before taking any medication is always a good idea.
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Types of Antacids
When gastric acid is present in excess or in areas where it is not supposed to be (such as the esophagus), tissue irritation and pain occurs. Antacids work by neutralizing the excess stomach acid. This provides immediate relief from the irritation and pain caused by the excessive gastric acid in the stomach, duodenum and esophagus.
Conditions in which treatment with antacids is prescribed include peptic ulcer disease, gastritis and acid reflux or gastroesophageal reflux disease. In conditions such as acid reflux, the antacids can provide relief from tissue irritation by coating the walls of the esophagus, thereby preventing tissue contact with gastric acid.
Although all antacids work in a similar way (by neutralizing acid), they differ in the nature of the active ingredients they contain. The active acid-neutralizing components in various antacids could be calcium, magnesium, aluminum or sodium bicarbonate. The differences in the nature of the active ingredients may result in the appearance of different signs and symptoms when these antacids are overused.
Symptoms of Antacid Overuse
The following are some of the typical signs and symptoms of antacid overuse. As mentioned previously, the exact signs and symptoms that occur in each individual case depend on the nature of the active ingredients in the antacid medications. Furthermore in may be compounded by the symptoms of the underlying acidity problem, like acid reflux or gastritis.
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Diarrhea and constipation
One of the most common side-effects of antacid overuse is constipation. This is especially the case with an overuse of calcium and aluminum containing antacids. The constipation that develops with antacid overuse usually becomes chronic, and does not improve even with a change in the type of antacid.
In such cases, one may try switching to an entirely different class of drugs, such as the drugs that suppress acid production in the stomach. Proton-pump inhibitors are examples of acid-suppressing drugs. Diarrhea is a less common side-effect of antacid overuse than constipation. Most cases of diarrhea that occur with antacid overuse happen in the case of magnesium-containing antacids.
Certain infections may also contribute to diarrhea that occurs with antacid overuse. Unlike constipation, diarrhea is a short-term side-effect of antacid overuse. However, continuous use of antacids may result in recurrence of diarrhea at different times.
Antacid overuse can result in a number of problems that affect the functioning of the muscles. Examples of some muscle problems that may occur with antacid overuse include muscular weakness, pain in the muscles, and twitching of the muscles. The exact mechanism of these problems varies on a case-to-case basis.
One of the mechanisms through which muscle problems may occur with antacid overuse is through a shift in the electrolyte levels in the blood. Excessive use of antacids may change the level of calcium, phosphate and magnesium in the blood. These electrolytes are essential for the proper functioning of the nerve and muscle cells.
Therefore, changes in the concentration of these electrolytes in the blood can affect the normal functioning of the muscles and nerves. The exact severity of muscular dysfunction depends on the duration and quantity of antacid overuse.
By neutralizing the acid, antacids like calcium or sodium bicarbonates change the pH of the blood. The resultant increase in the pH of the blood causes alkalosis, which could have serious consequences. One of the serious effects of alkalosis is a slowdown in the rate of breathing. By altering the rate of breathing, the body tries to compensate for the rise in the pH of the blood.
A slow breathing rate allows carbon dioxide to accumulate in the blood in the form of carbonic acid. Accumulation of carbonic acid compensates for the rise in pH of the blood. However, a slow breathing rate could become a problem for people who also suffer from renal, cardiovascular and respiratory problems.
Discontinuation of antacid use can gradually bring the pH of the blood to normal levels. This would also restore the normal rate of breathing.
In addition to playing an important role in the digestive process, the acid in the stomach also kills microbes that enter the body along with food. Neutralizing the stomach acid with chronic overuse of antacids not only hampers the digestion of food, but also weakens an important defense against microbial invasion.
In such situations, pathogenic microbes that would otherwise be destroyed in the stomach may gain entry into the gut and cause various diseases. These diseases may be characterized by bouts of diarrhea and abdominal pain. In some cases, the surviving pathogens may also cause systemic infections and affect other organs of the body.
Other symptoms of antacid overuse include lightheadedness, headache, nausea, dizziness, abdominal cramps, chalky taste in the mouth, excessive thirst, presence of white spots in feces, changes in mood, fatigue, abnormal urinary changes and weight loss.