Unconventional Acid Reflux Medicationsby Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional
There are many medications on the market designed to treat heartburn symptoms and repair tissue damage caused by acid reflux. But what happens when those medications fail to work for you, aren’t tolerated, interact with your other medications, or can’t be taken because of issues in your medical history? This may be when your doctor decides to try some of the infrequently used, or unconventional, acid reflux medications. Here are a few of the medications that you may not be familiar with but can help to banish the burn.
Prokinetics include medications like bethanechol (Urecholine), cisapride (Propulsid), and metoclopramide (Reglan). Prokinetics are thought to help reduce acid reflux by strengthening the lower esophageal sphincter (LES) and allowing stomach contents to empty faster. These medications are generally only given when standard treatments don’t work, or in severe cases of acid reflux, because they have the potential for more dangerous side effects.
Sucralfate is a medication that is often used for the treatment and prevention of duodenal ulcers. It can also be used for acid reflux as determined by your physician. Sucralfate works by coating the esophagus and/or stomach to prevent the acidic stomach contents from causing damage and to allow previous damage (such as ulcers or esophagitis) time to heal. As with any medication, your physician needs to weigh the risks and benefits. For example, sucralfate contains aluminum, which might cause issues in patients who have kidney disease.
Transient lower esophageal sphincter relaxation (TLESR) reducers
TLESR reducers are medications that work on the underlying mechanism of acid reflux by reducing the relaxation of the LES, which is what allows stomach contents to splash into the esophagus. One such medication is baclofen, which has shown promise in reducing symptoms as well as reducing the amount of stomach acid itself. If you have kidney disease, seizures, or a history of heart disease or stroke, then this medication may not be the right one for you. Talk with your physician about the risks versus benefits of TLESR reducers.
Tricyclic antidepressants or selective-serotonin reuptake inhibitors (SSRIs) have been shown to change the pain perception of acid reflux in some patients and may improve contraction abnormalities. While changing the perception of pain may improve the quality of life for a patient, it is important to note that the potential for damage to the esophagus remains and requires monitoring by your physician.
Not all medications for acid reflux work for every individual, which is why it is important to tailor your medication plan with your physician. It can take some time to find the right combination of medications that will reduce your acid reflux pain with minimal side effects. If you have tried the standard medications such as proton pump inhibitors (PPIs) and H2 blockers without success, it may be time to talk with your physician about some of these more unconventional acid reflux medications.