Question: What are some of the over-the-counter medications that are used to treat GERD (gastroesophageal reflux disease), how do they work and what are the risks/side effects?
Answer: Over-the-counter medications can be divided into three broad categories. First for the most simple disease are the antacids Maalox and Mylanta. These medications works by neutralizing the acid in the distal esophagus which is the lower part of the esophagus where reflux tends to occur.
The stronger classes of medications histamine-receptor blockers such as Zantac and proton pump inhibitors such as Prilosec, are more effective in patients with more severe disease. These medications both work by decreasing the amount of acid secreted by the stomach. Proton pump inhibitors in general are more effective by a decreasing the amount of acid produced in the stomach by well over 90 percent.
Overall these medications are very safe, but in certain select populations caution should be used with long term therapy. In particular the proton pump inhibitors have been linked to higher rates of osteoporosis, mostly in women, and infections in hospitalized patients. These concerns are not relevant to the outpatient treatment of gastroesophageal reflux disease, especially in young or middle-aged men.