Greater Knox Pharmacy
Monday | 8am - 7pm |
Tuesday | 8am - 7pm |
Wednesday | 8am - 7pm |
Thursday | 8am - 7pm |
Friday | 8am - 7pm |
Saturday | 8am - 2pm |
Sunday | Closed |
Reflux is also known as Heartburn, Acid Reflux, Indigestion, Gastro Oesophageal Reflux Disease (GORD or GERD).
Once food is chewed and swallowed, it is pushed by muscular waves down the oesophagus (food tube) and through a sphincter (or muscle ring) into the stomach. Food can remain in the stomach from 2 to 5 hours in order to be digested. Sometimes, even in healthy individuals, the contents of the stomach squeeze up through the sphincter and back into the oesophagus. This is called 'reflux' (also known as gastro-oesophageal reflux disease, indigestion or heartburn) and feels like a burning sensation behind the breastbone.
Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week.
Most people can manage the discomfort of reflux with lifestyle changes and over-the-counter medications. People with GERD may need stronger medications or rarely, surgery to ease symptoms.
Common signs and symptoms of reflux and GERD include:
If you have nighttime acid reflux, you might also experience:
Some symptoms may require urgent medical attention:
Diagnosis is usually made based on symptoms, medical history and physical examination. A diagnosis can be confirmed with a two week trial of reflux medication.
When a patient experiences common symptoms of gastroesophageal reflux disease, namely heartburn and/or acid regurgitation, additional tests prior to starting treatment are typically unnecessary. If symptoms do not respond to treatment, or if other symptoms such as weight loss, trouble swallowing or internal bleeding are present, additional testing may be necessary.
To confirm a diagnosis of GERD, or to check for complications, your doctor might recommend:
Treatment should always start with reducing or eliminating causes and risk factors. Some measures include:
Most symptoms can be managed with lifestyle modifications. If symptoms are not sufficiently controlled, then an initial trial of antacids is appropriate. Antacid tablets are less effective than liquid preparations but are more convenient.
If antacids do not give adequate relief, use either an H2-receptor antagonist or a proton pump inhibitor (PPI) at the standard dose.
⚠ ** Seek medical advice from your doctor. **
Patients often need regular drug therapy in addition to diet and lifestyle modification.
Start with a proton pump inhibitor (PPI) at standard dose. PPIs are generally preferred to H2-receptor antagonists for initial therapy. Response to a trial of PPI therapy can confirm the diagnosis.
The initial course of treatment should be 4 to 8 weeks. When symptom control is adequate, step down to maintenance therapy.
If initial PPI therapy provides adequate symptom control, therapy may be titrated down and continued at the lowest dose and frequency that controls symptoms, or stopped.
If symptoms recur during step-down therapy, advise patients to return to the lowest PPI dosage that provided effective symptom control.
Symptom recurrence may be prevented by gradually reducing the PPI dose before stopping, or using on-demand or regular therapy with an H2-receptor antagonist or antacid.
They work to neutralise the acid in the stomach. They act fairly quickly and last between 2-6 hours. Take between meals or at bedtime when symptoms occur or you expect they might occur. Tablets should be chewed or sucked before swallowing for the best effect. Liquids work better than tablets, but are less convenient.
Antacids can reduce the effect of a number of other medicines taken by mouth. The best way to avoid a problem is to separate taking antacids and other medicines by at least 2 hours.
Brand | Ingredients | Form | Pregnancy | Breastfeeding | Available |
---|---|---|---|---|---|
Gaviscon Dual Action | Alginate, Sodium Bicarbonate, Calcium Carbonate | Liquid, Chewable Tablets | Category A Safe |
Safe | OTC |
Gaviscon Double Strength | Alginate, Potassium Bicarbonate, Calcium Carbonate | Liquid | Category A Safe |
Safe | OTC |
Mylanta 2go Double Strength | Aluminum Hydroxide, Magnesium Hydroxide, Simethicone | Chewable Tablets | Category A Safe |
Safe | OTC |
They reduce acid production from the stomach, and provide longer relief than antacids for up to 12 hours even though they don’t work quite as fast.
Brand | Ingredients | Form | Pregnancy | Breastfeeding | Available |
---|---|---|---|---|---|
Ausfam | Famotidine 20mg once or twice daily as required | Tablets | Category B1, Probably Safe | Considered Safe | Prescription |
Tacidine, Nizac | Nizatidine 150mg once or twice daily as required | Tablets | Category B3, Probably Safe | Considered Safe | Prescription |
Pregnancy: Category B3. If antacids and H2-blockers are ineffective, use Omeprazole.
Breastfeeding: If antacids and H2-blockers are ineffective, use Omeprazole.
They block acid production and heal the oesophagus. They are stronger acid blockers than H2-receptor antagonists.
Brand | Ingredient and dose | Form | Available |
---|---|---|---|
Nexium | Esomeprazole 20mg once daily | Tablets, Capsules | OTC, Prescription |
Zoton | Lansoprazole 30mg once daily | Tablets | Prescription |
Losec, Acimax | Omeprazole 20mg once daily | Tablets, Capsules | Prescription |
Somac | Pantoprazole 40mg once daily | Tablets, Granules | Prescription | Pariet | Rabeprazole 20mg once daily | Tablets | Prescription |
Some PPIs are available at pharmacies without a doctor’s prescription. They usually come at a lower dose than the prescription strength and in smaller packs. They can be used for managing mild intermittent symptoms.
Brand | Ingredient and dose | Form | Pack Size | Available |
---|---|---|---|---|
Nexium | Esomeprazole 20mg once daily | Tablets, Capsules | 7, 14 | OTC |
Somac | Pantoprazole 20mg once daily | Tablets | 7, 14 | OTC |
Pariet | Rabeprazole 10mg once daily | Tablets | 7 | OTC |