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Digestive issues are among the most common health complaints, and knowing which over-the-counter medication to choose can help you find relief quickly and safely.
Antacids: For Heartburn and Acid Indigestion
How They Work
Antacids neutralize stomach acid to provide quick relief from heartburn, acid indigestion, and upset stomach.
Types of Antacids:
- Calcium carbonate (Tums, Rolaids): Fast-acting, also provides calcium
- Magnesium hydroxide (Milk of Magnesia): Can cause diarrhea
- Aluminum hydroxide (Amphojel): Can cause constipation
- Combination products (Mylanta, Maalox): Balance effects of different ingredients
When to Use Antacids:
- Occasional heartburn after meals
- Acid indigestion
- Upset stomach from spicy or acidic foods
- Quick relief needed (work within minutes)
Precautions:
- Don't use for more than 2 weeks without consulting a doctor
- Can interfere with absorption of other medications
- High sodium content in some products
- Calcium-based antacids can cause kidney stones with overuse
H2 Blockers and PPIs: For Frequent Heartburn
H2 Receptor Blockers:
- Famotidine (Pepcid AC)
- Ranitidine (previously available)
- Cimetidine (Tagamet HB)
Proton Pump Inhibitors (PPIs):
- Omeprazole (Prilosec OTC)
- Lansoprazole (Prevacid 24HR)
- Esomeprazole (Nexium 24HR)
When to Use:
- Frequent heartburn (2+ days per week)
- Prevention of heartburn before trigger foods
- Longer-lasting relief needed
Anti-diarrheal Medications
Loperamide (Imodium A-D)
Slows intestinal movement to reduce frequency of bowel movements and improve stool consistency.
When to Use:
- Acute diarrhea from viral infections
- Traveler's diarrhea
- IBS with diarrhea (with doctor approval)
- When you need to control symptoms temporarily
When NOT to Use:
- Bloody or black stools
- High fever (above 101.3°F/38.5°C)
- Suspected bacterial infection
- Severe abdominal pain
- Children under 2 years old
Bismuth Subsalicylate (Pepto-Bismol)
Provides anti-diarrheal effects plus anti-inflammatory and antimicrobial properties.
Additional Benefits:
- Reduces nausea
- Helps with upset stomach
- May help with mild bacterial diarrhea
- Prevention of traveler's diarrhea
Laxatives: For Constipation Relief
Bulk-forming Laxatives (First Choice)
- Psyllium (Metamucil)
- Methylcellulose (Citrucel)
- Polycarbophil (FiberCon)
How they work: Add bulk and water to stool
Onset: 12 hours to 3 days
Safest for long-term use
Osmotic Laxatives
- Polyethylene glycol (MiraLAX)
- Magnesium hydroxide (Milk of Magnesia)
- Lactulose
How they work: Draw water into intestines
Onset: 30 minutes to 6 hours
Stimulant Laxatives (Short-term use only)
- Bisacodyl (Dulcolax)
- Senna (Senokot)
How they work: Stimulate intestinal contractions
Onset: 6-12 hours
Can cause dependency with overuse
Stool Softeners
- Docusate (Colace)
How they work: Allow water to penetrate stool
Best for: Preventing hard stools, post-surgery
General Guidelines for Digestive Medications
When to See a Doctor:
- Symptoms persist despite treatment
- Blood in stool or vomit
- Severe abdominal pain
- Unexplained weight loss
- Changes in bowel habits lasting more than a few days
- Signs of dehydration
Lifestyle Modifications:
- Stay hydrated
- Eat smaller, more frequent meals
- Increase fiber gradually
- Identify and avoid trigger foods
- Manage stress
- Regular exercise
Remember: While OTC digestive medications can provide relief, persistent or severe symptoms should always be evaluated by a healthcare provider to rule out underlying conditions.