Over the Counter Drugs: Tummy Turmoil : Part 2

by Food and Drug Administration (FDA)

(Page 2 of 2)

Aluminum salts (ALternaGEL, Amphogel, Rolaids, and others)-Aluminum salts can constipate, so they're usually combined with magnesium salts to counter this effect. Overuse can weaken bones, especially in people with impaired kidney function, leading to conditions such as osteomalacia (softening of the bones, which causes symptoms such as tenderness, muscular weakness, and weight loss).

Magnesium salts (Camalox, Gelusil, Maalox, Mylanta, and others)-These salts have a laxative effect, so they're usually combined with aluminum salts; Camalox also has calcium salts. Very prolonged use may cause kidney stones. Too much magnesium in the blood can cause heart, central nervous system, and kidney problems.

As this list shows, some antacid products contain a combination of antacid ingredients. Some also contain simethicone, which breaks up gas bubbles, making them easier to eliminate from the body.

"Antacids are fast-acting drugs," says Hugo Gallo-Torres, M.D., a medical officer in FDA's division of gastrointestinal and coagulation drug products. "They should bring relief within 15 to 20 minutes of each episode. If, after several episodes, there is no relief, then something else may be going on, something that requires a physician's evaluation."

Antacids may interact with many drugs. Gallo-Torres advises consulting a doctor before using antacids if you have a condition that requires adjusting sodium in your diet, or if you are taking a prescription medicine.

Overindulgence

Bismuth subsalicylate is recommended for overeating and drinking excessively. Bismuth also has some antibacterial effect. The product, sold as Pepto-Bismol and generic brands, may cause a temporary, harmless darkening of the tongue or stool.

FDA has proposed that products containing bismuth subsalicylate have labeling warning not to give the drug to children and teenagers who have or are recovering from chickenpox, flu symptoms (nausea, vomiting or fever), or flu. The warning is needed because, like aspirin, bismuth subsalicylate is a salicylate and may be associated with an increased risk of Reye syndrome, a rare but serious illness that can occur in children and teenagers with those illnesses.

Other proposed warnings advise users not to take the drug if they're allergic to any salicylate, and to consult a doctor first if they have diabetes, gout or arthritis or if they take blood-thinning medicine.

Users are also advised to stop taking the drug if they have ringing in the ears. Rachanow explains: "This may happen when too much drug is taken or when another salicylate, such as aspirin, is taken at the same time."

Viral Infection

Nausea, vomiting and diarrhea may also be due to mild viral gastrointestinal infection. Children are especially susceptible. A doctor should be consulted if vomiting or diarrhea recur or persist, because dehydration or a chemical imbalance may result and require treatment. It is very important that patients recovering from viral gastrointestinal infection drink plenty of fluids.

General Advice

With stomach upsets in general, it's a good idea to call the doctor if symptoms last more than a few days. A doctor should be called if symptoms become severe-for instance:

• continuous vomiting or diarrhea
• extreme discomfort or pain in the gastrointestinal tract
• black stool (unless the drug you took, such as Pepto Bismol, contains bismuth subsalicylate)
• visible blood in the stool
• vomiting of blood or material that looks like coffee grounds, but which is actually digested blood.

Prolonged self-treatment may mask a more serious condition, such as an ulcer or cancer.

Women who are pregnant or breast-feeding should consult their doctors before taking any drugs.

Fortunately, most upset stomachs get better by themselves or require minimal treatment. As with any medicine, it's important to read an OTC drug's entire label and follow directions carefully. And, as with any illness, it's important to know when to call the doctor.

Ways to Avoid Heartburn

The best way to deal with heartburn or indigestion is to avoid them in the first place. Simple preventive steps are:

Avoid big meals. Your stomach must work long and hard to process them, which means it must produce a lot of acid. It helps to eat more frequent, smaller meals.

After you eat, don't lie down right away. If you do, you're more likely to have heartburn, because gravity is now preventing food from going speedily to the intestines.

Eat your last full meal at least three hours before bedtime. When you go to sleep, everything slows down, including your digestive system, so food you've eaten right before bedtime will stay in your stomach longer. It won't feel good.

Sleep with your head and shoulders propped up 6 to 8 inches, so that your body is at a slight angle. This gets gravity working for you and not against you. Digestive juices in your stomach are then more likely to head south, for your intestines, instead of back up into your esophagus to cause a burning sensation.

Avoid tight-fitting garments. They can literally compress your stomach, making it more likely that the stomach's acid contents will back up into your esophagus.

Avoid foods that contain a lot of acid, such as citrus fruits and tomatoes, and any other food that gives you problems.

Cut down on caffeine. It makes your stomach produce more acid. Caffeine-heavy items include coffee, tea, chocolate, and some sodas.

Cut down on alcohol and smoking. Both irritate the lining of your stomach and tend to lower esophageal sphincter pressure. When this happens, it's easier for the stomach's acid contents to shoot back up your esophagus.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.