10 Side Effects of Antacids
Antacids are a class of drugs used to neutralize stomach acidity for the treatment of indigestion, upset stomach, or heartburn. The medication is easily available over the counter and can be taken to help manage symptoms of gastroesophageal reflux disease.
Treatment using antacids is symptomatic. Symptoms usually begin when there are excessive amounts of acids produced in the stomach. Antacids contain alkaline that help neutralize gastric acid and, therefore, reduces damage and relieves pain. Antacids that contain magnesium and aluminum work rapidly to decrease acidity in the stomach. Antacids only work on existing acid in the stomach and do not prevent the production of acid.
Antacids can be used alone or in combination with other medications that control acid production such as proton pump inhibitors and H2 blockers. However, like all other medication, antacids also have side effects if taken frequently.
Side Effect #1: Diarrhea
Diarrhea occurs when there are three or more episodes of watery, loose, and liquid stools a day. Prolonged diarrhea can result in dehydration due to fluid loss. Signs and symptoms include tachycardia, decreased urination, irritability, decreased responsiveness, and decreased skin turgor.
The commonest cause of diarrhea is due to an infection of the intestines due to a viral, bacterial, or parasitic infection. Other causes include lactose intolerance, hyperthyroidism, celiac disease, irritable bowel syndrome, and inflammatory bowel disease. Versions of antacids with magnesium have been reported to cause diarrhea.
Side Effect #2: Constipation
Constipation refers to bowel movements that are hard to pass or infrequent. Stools in constipation are often dry and hard. Other symptoms of constipation include abdominal bloating, abdominal pain, and a feeling of incomplete evacuation. Constipation can lead to complications such as anal fissures, hemorrhoids, and fecal impaction.
There are various causes of constipation such as irritable bowel syndrome, hypothyroidism, diabetes, pelvic floor disorders, and side effects of medications like opioids, antacids, anticholinergics, and calcium channel blockers.
Side Effect #3: Kidney Stones
Kidney stones or urolithiasis is a condition that occurs when there is a solid piece of material in the urinary tract. These stones usually form in the kidneys and leave the body through the urinary tract.
While a small stone may pass without symptoms, a stone more than 5 millimeters can cause a blockage in the urinary tract resulting in severe pain in the abdomen and lower back. Other associated symptoms of kidney stones include painful urination, hematuria, nausea, and vomiting. Although rare, antacids containing calcium may cause kidney stones.
Side Effect #4: Osteoporosis
Osteoporosis is a condition where there is weakness of the bone. This disease increases the risk of broken bones and it is the leading cause of broken bones among the elderly. Bones that are most commonly affected are the bones of the forearm, vertebrae in the spine, and hip bones. Symptoms are usually absent until there is a broken bone.
In osteoporosis, the bones may weaken to the point where minor stress causes the bone to break. It can also result in chronic pain, limitation of movement, and inability to carry out daily activities. Long-term use of antacids that contain aluminum may increase the likelihood of osteoporosis.
Side Effect #5: Headache
A headache describes pain that is felt anywhere in the region of the neck or head. There are various types of headaches such as tension type headaches, cluster headaches, and migraines. Although common and generally harmless, frequent headaches can have a negative impact on quality of life as it may affect school, employment, and relationships. It also increases the risk of depression.
Some causes of headaches include fatigue, sleep deprivation, dehydration, stress, and side effects of medications (such as antacids). Headaches are usually managed using pain medication such as paracetamol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen.
Side Effect #6: Nausea
Nausea refers to an unpleasant sensation where there is discomfort and an involuntary urge to vomit. While there may not be any pain, prolonged nausea can be debilitating as it places discomfort on the back of the throat, chest, and upper abdomen. Like pain, nausea is one of nature’s way of teaching the person to avoid potentially harmful triggers.
It is a nonspecific and common symptom that can be seen in various causes such as motion sickness, hypoglycemia, dizziness, migraines, gastroenteritis, and food poisoning. It has also been reported as a potential side effect of antacids. Management of nausea usually involves the use of antiemetics such as ondansetron, metoclopramide, and promethazine.
Side Effect #7: Muscle Weakness
Muscle weakness or myasthenia occurs when there is lack of muscle strength. It can be generally divided into true or perceived muscle weakness. True weakness occurs in conditions such as inflammatory myopathy, muscular dystrophy, and myasthenia gravis. It can also occur when there is electrolyte imbalance such as hypokalemia. Perceived weakness occurs when an individual feel that more effort is necessary to exert the same force despite having normal muscle strength. This can be seen in conditions such as chronic fatigue syndrome.
Muscle weakness may occur as a side effect of aluminum-containing antacids as it binds to phosphate resulting in low phosphate levels, which in turn causes muscle weakness.
Side Effect #8: Dizziness and Fainting
Dizziness refers to the impairment in stability and spatial perception. It is a term that can be used to describe disequilibrium (poor balance), presyncope, and vertigo (the sensation of spinning surroundings). Dizziness may be associated with other symptoms such as nausea and vomiting.
Fainting or syncope occurs when there is sudden loss of muscle strength and consciousness that usually has a spontaneous recovery. Dizziness and fainting are unlikely but serious side effects of antacids. Patients who experience fainting or dizziness should seek medical attention.
Side Effect #9: Stomach Cramps and Flatulence
A cramp occurs when there is an involuntary and sudden muscle contraction. Stomach cramps occur when the smooth muscles in the abdomen contract and is often associated with abdominal pain.
Flatulence refers to the state where there are gases in the stomach or intestine resulting in the breaking of wind or passing of gas through the anus. Stomach cramps and flatulence are side effects that have been reported among patients who have taken antacids.
Side Effect #10: Hypermagnesemia
Hypermagnesemia refers to a high level of magnesium in the blood. It can lead to symptoms such as decreased breathing rate, weakness, decreased reflexes, and confusion. If severe, it can cause complications such as cardiac arrest and low blood pressure.
Hypermagnesemia is most commonly caused by the ingestion of antacids, especially among those with kidney failure. Other potential causes include seizures, prolonged ischemia, and tumor lysis syndrome. Hypermagnesemia occurs if the magnesium level in the blood is more than 1.1 mmol/l, while severe cases occur if the level is more than 2.9 mmol/l. Electrocardiogram changes may also be present.
