Rx Note

Introduction Heartburn is a form of dyspepsia, or more formally known as gastro-oesophageal reflux disease (GERD) . Symptoms are caused when there is reflux of gastric contents, particularly acid, into the oesophagus, which irritate the sensitive mucosal surface (esophagitis). Symptoms Patients will often describe the symptoms of heartburn - typically a burning/pain felt in the stomach, passing upwards behind the breastbone (retrosternally). Regurgitation is defined as the perception of flow or refluxed gastric content into the mouth or hypopharynx. It is often brought on by bending or lying down, which make leakage of acid up the oesophagus more likely. Aggravating Factors Alcohol, caffeine, smoking, overweight, stress, a large meal and medications are known to aggravate heartburn. Moreover, half of all pregnant women are estimated to suffer from heartburn (often begins in mid-to-late pregnancy). Referral Referral for further investigation is recommended: In patients aged <18 y...

Introduction Antacids (usually containing aluminium or magnesium compounds) can often relieve symptoms in dyspepsia . They are best given when symptoms occur or expected, usually between meals and at bedtime. Choices Onset and duration Liquid preparations have a faster onset of action. Sodium and potassium salts are the most highly soluble, which enables them to have a quicker onset , but are shorter acting. Magnesium and aluminium salts are less soluble, so these have a slower onset, but longer duration of action. Calcium salts have the advantage of being quick acting and have a prolonged action. It is therefore common for manufacturers to combine two or more antacid ingredients together to ensure a quick onset and prolonged action. Precautions and side effects Different from magnesium hydroxide and aluminium hydroxide, sodium bicarbonate may cause "belching" of carbon dioxide, which makes it less suitable in patients who have flatulence. Magnesium salts tend to cause dia...