When To Take Antisecretory Drugs And Antacids In Relation To Food

When taking ulcer drugs such as antisecretory drugs and antacids, they are to be taken before or after food. But when the direction is not adhered to, it may most likely not work. It is very important to follow the dosing guidelines along with lifestyle modification. This post will focus on the dosing direction.

Antisecretory Drugs And Antacids

Antisecretory agents and antacids are the main drugs used in management of gastroesophageal reflux disease (GERD) and related conditions like ulcer. Antisecretory drugs include proton pump inhibitors (PPI) and H2 inhibitors. Examples of PPI are omeprazole and lansoprazole while examples of H2 inhibitors are cimetidine and ranitidine. Also, salts of magnesium, calcium, carbonate, etc are examples of antacids.

Read Also: Management of stomach ulcer

But many people don't get therapeutic results after using them. This is because many people don't use it how it is supposed to be used.

GERD And Ulcer

Before we go on, let us take a brief look at GERD and related disease. GERD is a condition where stomach acid or acidic gas flows back through the esophagus back into the mouth. And Ulcer is a sore in the stomach or small intestine. Both conditions cause pain. Severity of pain depends on the severity of condition. Complications of ulcer are leaking of stomach content into the body. It can be fatal but very rare.

Cause Of Ulcer

Treatment of ulcer with antacids and antisecretory drugs

The major cause is the abuse of non steroidal antiinflammatory drugs (NSAIDs) and a bacterial common in the stomach that may proliferate called H. pylori. The cause of this proliferation is not known. Spicy food, caffeine, stress, acidic foods such as orange, tobacco, alcohol, oily food, hard food to digest, milk, too much acid secretion, etc makes it worse.

How Stomach Acid Is Produce

Acid is secreted in the stomach when a person perceives the aroma of food and about to eat. The stomach pH falls from the normal 4 to 2 or 1. The acid aids in the digestion of food.

After eating, the food uses up most of the acid. As the food digests, some acid is left in the stomach anticipating more food. But as no extra food comes in, the acid wears off over time. The stomach and small intestine is protected from this acid. But when there is an ulcer or GERD condition, the acid makes them worse.

Treatment is the use of antisecretory drugs, antacids and when a bacterial is involved in antibiotics. Unfortunately, most people don't use antisecretory drugs and antacids well. This is resulting in a lot of treatment failure.

Antisecretory Drugs (Acid Suppressant)

These drugs inhibit gastric acid secretion in the stomach. They do this by blocking proton pumps. Proton pump is responsible for the release of stomach acid. To be able to inhibit gastric acid, the drug must be taken some minute before food when the stomach acid has not been released. It allows the antisecretory drugs time to prevent the proton pump which is responsible for the release of the acid in the stomach.

Now when taken after food, this is what happens. For cimetidine, food interferes with the effect by decreasing absorption and inability to suppress meals induce acid secretion. For PPI, the food delay absorption, bioavailability and peak concentration. This leads to delayed activity. Meanwhile, the food has activated the proton pump already and acid has been released into the stomach.

Food offers temporary relief from ulcer pain. But as the food leaves the stomach, the pain starts. This is because some acid is left in the stomach. And the drug preventing the proton pump now won't have much effect. The drug behaves as if it is not working. So the best time to take antisecretory drugs is 15 minutes to an hour before food.

Most PPI can offer an acid suppressive effect for 24 hours. But when it is not, a second dose is required. This should also be done before food.

Antacids

Antacids neutralize stomach acid or inhibit the activity of pepsin. pepsin is a stomach enzyme active in the presence of acid. It is believed to be one of the things that make ulcers worse. 

The right time to take antacid is a matter that a lot of people take lightly. Between before food and after food and the right time is another debate. Let us see when it works best.

After eating, peristalsis is slow. That means anything in the stomach moves very slowly. For drugs that will get absorbed into the body, they slowly get to the area of absorption and slowly enter the system. This is what happens to antisecretory agents taken immediately after food. As for antacids, they are not absorbed into the system (except for some of their excipients or salts). They will move slowly along with the food and binds to food, especially protein and will be used up in the process. This they do by binding to and neutralizing the stomach acid, thus stifling the cleaving of the protein in the stomach.

Read Also: The cause of stomach ulcer

What then happens when an antacid is taken on an empty stomach? Because there is no food in the stomach, peristalsis is fast and the antacid will move very fast. In about 20-40 minutes, it has moved past the stomach. So, if the body produces a little acid after that, ulcer pain or GERD is back.

But when the antacid is taken like an hour after eating, it allows time for stomach acid to digest the food. The antacid then neutralizes any acid remaining in the stomach. And because the stomach is expecting more food, peristalsis is slow. It takes up to three hours. Antacids are best given on an empty stomach. Antacids should be used when you have symptoms or think you will get them soon.