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What to Do if Your Acid Reflux Medication Is Not Working Effectively

cartoon man holding stomach and chest having pain

If you find yourself reaching for acid reflux medication more than once a week, it’s time to see your healthcare provider for a thorough digestive health evaluation. But besides medications, there are other solutions that can give you relief from acid reflux symptoms. Please continue reading to learn more about what to do if your acid reflux medication is not working.

What are heartburn, acid reflux, and gastroesophageal reflux disease?

First, let’s take a quick look at the various terms used to describe burning chest pain, difficulty swallowing, and other symptoms that occur in the lower chest, especially after a fatty or heavy meal. 

The burning pain, commonly called acid indigestion or heartburn, is a symptom of acid reflux. Acid reflux occurs when the lower esophageal sphincter (a sphincter muscle that acts like an anti-reflux barrier) is weak. A weak sphincter allows stomach acid to back up into the esophagus (food pipe) and irritate the tissues, causing heartburn symptoms. Gastroesophageal reflux disease (GERD) is a more severe and longer-lasting form of acid reflux. 

It is okay to treat occasional heartburn and acid reflux symptoms with over-the-counter antacids. However, you should be properly evaluated for GERD by a healthcare professional if your symptoms occur frequently. Untreated or refractory gastroesophageal reflux disease can lead to serious health complications, including esophageal cancer.

Why won't my acid reflux go away even with medication?

Many people with heartburn who are taking GERD treatment still experience breakthrough symptoms. There could be several reasons why your acid reflux medication is not working effectively:

  • You have some other condition that mimics the symptoms of GERD. It’s important to see a healthcare professional to get an accurate diagnosis and appropriate treatment.
  • You are suppressing the symptoms of acid reflux but not addressing the underlying cause. Your doctor can suggest the appropriate treatments for your gastrointestinal disorders.
  • You are eating fried, fatty, and spicy foods indiscriminately or eating late at night. Heartburn medications can relieve your symptoms; however, constant consumption of the triggering food can lead to breakthrough symptoms of GERD.
  • You’re not taking your acid reflux medication correctly (you’re either taking the wrong dose, taking the medicine at the wrong time, or missing doses). Talk to your doctor or pharmacist if you’re unsure how to take your GERD medication.
  • You’re taking over-the-counter antacids and need something stronger. If your doctor diagnoses gastroesophageal esophageal reflux disease (GERD), you may be given a prescription medicine. 

What should I do if my acid reflux won't go away?

If you are experiencing a burning sensation in your chest more than once a week and taking medication frequently, it’s time to seek professional medical advice from a healthcare professional. 

Your doctor will perform a thorough evaluation and make sure other medical conditions like heart disease are not causing your symptoms. They will also ensure your chronic acid reflux treatment is safe and adequate. 

If the medications prescribed by your doctor do not provide relief from heartburn, down the line to treatment, there are surgical procedures available that can address the underlying problem.

What can I take when omeprazole doesn't work?

Antacids

Most people start by treating their acid reflux with over-the-counter medicines. Antacids like Tums, Mylanta, and Rolaids provide quick relief from acid reflux symptoms by neutralizing gastric acid in the stomach contents. But these heartburn drugs do not address the underlying cause of excess stomach acid, and they do not heal a damaged esophagus. Overuse of antacids can cause diarrhea and lead to health conditions like chronic kidney disease. Antacids should be taken after meals and at bedtime to achieve maximum efficacy.

H2 Receptor Blockers

H2 receptor blockers like Pepcid AC, Axid AR, and Tagamet HB work by decreasing the amount of stomach acid. This drug class is used to treat mild to moderate GERD. They are slower to start working but provide longer-lasting relief (up to 12 hours) compared to antacids. Long-term use of H2 receptor blockers can lead to tolerance and reduce the efficacy of therapy.

Proton Pump Inhibitors (PPIs)

Proton pump inhibitors are stronger than H2 blockers and are often prescribed to GERD patients. PPIs block stomach acid production and also heal the esophageal lining. Examples include lansoprazole (Prevacid), omeprazole (Prilosec), and the combination product - Zegerid, containing omeprazole and sodium bicarbonate (baking soda). Long-term use of PPIs can lead to vitamin B12 deficiency, Clostridium-difficile (C.Diff) associated diarrhea, low blood magnesium levels, and an increased risk of bone fractures.

Alternative Medicine

The safety and efficacy of alternative treatments, such as traditional Chinese medicine, herbal remedies, etc., are not scientifically proven by clinical trials. Always consult a healthcare provider before taking any alternative medicine to avoid drug interactions leading to undesirable side effects.

Surgical Intervention for GERD

Most GERD patients benefit from medications and lifestyle changes and get relief from their symptoms. However, if they do not work, your doctor may recommend a minimally invasive procedure such as transoral incisionless fundoplication (TIF procedure), a Stretta procedure, laparoscopic fundoplication, or placement of the LINX Reflux Management System.

What is the strongest prescription for GERD?

Proton pump inhibitors (PPIs) are the strongest prescription medications available for treating GERD. However, if you experience heartburn frequently, it’s important to seek medical advice from a health professional. PPIs should not be used constantly for the long term without the supervision and guidance of a healthcare professional. Long-term use of PPIs can lead to acute renal disease, chronic kidney disease, an increased risk of bone fractures, worsening cardiac conduction defects (a rare inherited heart rhythm disorder), community-acquired pneumonia, and C. difficile intestinal infection.

Acid reflux medication not working effectively? Try this instead…

Lifestyle modifications can help many patients with acid reflux symptoms. Even if you are prescribed a GERD medication, long-term lifestyle changes are essential for maintaining GERD symptoms. Some of the lifestyle changes you can try include:

  • Quit smoking. Smoking makes the muscles in the lower esophagus weaker.
  • Lose weight. Excess weight puts pressure on the stomach and can worsen acid reflux. Losing weight may provide relief from heartburn.
  • Wear loose-fitting clothes. Tight clothes can put pressure on the stomach and increase acid reflux. 
  • Elevate your head when lying down. Raising your head by 6-9 inches can help the stomach acid flow downwards. 
  • Avoid certain foods and drinks that aggravate your acid reflux, such as spicy and fatty foods, alcohol, caffeine, and citrus juices. 
  • Avoid eating late at night. Eat your last meal at least 3 hours before going to bed or lying down.
  • Eat smaller, more frequent meals.
  • Practice mindfulness, meditation, and yoga for stress relief. Strong emotions can trigger GERD symptoms.


References:

  1. https://www.medscape.com/answers/176595-45436/what-is-the-strongest-medication-available-for-the-treatment-of-gastroesophageal-reflux-disease-gerd
  2. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/transoral-incisionless-fundoplication 

https://stanfordhealthcare.org/medical-treatments/e/esophagus-reconstruction.html