Reflux Medications Overview

Medications to Control Acid Reflux

Common Medications

• H2 Blockers
  • Example: Pepcid
• Proton Pump Inhibitors (PPIs)
  • Example: Prilosec

Mechanism of Action

1. Stomach Lining and Cells
   • Two Main Cells: ECL Cells and Parietal Cells
   • Neurotransmitters & Receptors
     • Acetylcholine: Attaches to muscarinic receptors on both cell types
     • Histamine: Attaches to H2 receptors on parietal cells
2. Acid Secretion Process
   • Activation of both receptor types in parietal cells signals proton pumps to secrete acid

Medication Functions

• H2 Blockers
  • Block H2 receptors on parietal cells
  • Prevent histamine from attaching
  • Result: Weaker signal from muscarinic receptor; reduced acid secretion
• Proton Pump Inhibitors
  • Act downstream in the activation pathway
  • Shut down proton pumps
  • Result: No acid secretion, regardless of parietal cell activation
  • Note: PPIs are stronger than H2 blockers

Long-term Use and Alternatives

Side Effects

• Both H2 Blockers and PPIs are not recommended for long-term use due to side effects

Alternative: Sodium Alginate (from seaweed)

• Mechanism
  • Coats esophagus and stomach lining
  • Forms a floating gelatinous raft on stomach secretions
  • Prevents reflux by plugging the esophageal opening
• Usage
  • Must be taken after every meal and at bedtime
  • Digested over time by the stomach

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Patient education video sponsored by RefluxRaft