What types of drugs might I be prescribed, and how do they work?

The most widely used drugs for reflux disease are antacids (anti-acid tablets and mixtures), which temporarily neutralise stomach acid and reduce its damaging effects. In certain products, antacids are combined with a substance called alginate, which forms a barrier over the lining of the lower gullet.

If you suffer from severe or persistent heartburn, it is likely that you will be prescribed a drug that reduces acid production in the stomach. These include H2 receptor antagonists, such as cimetidine, famotidine, nizatidine or ranitidine, and proton pump inhibitors (PPIs), such as esomeprazole, lansoprazole, omeprazole, pantoprazole or rabeprazole. If you have difficulty swallowing, there are available drugs which can be dispersed in water or dissolve on the tongue such as lansoprazole oro-dispersible tablets and omeprazole multi unit pellet system (MUPS).

Other drugs used in reflux disease are those that reduce the chance of acid flow from the stomach back into the gullet. They do this mainly by improving the function of the valve between the stomach and the oesophagus, which encourages acid to flow in the proper direction. These drugs are called motility stimulants and include metoclopramide and domperidone.

If you appear to have a peptic ulcer and are positive on testing for H. pylori, most doctors now prescribe a course of antibiotics. This is usually a combination of two antibiotics and a PPI, called triple therapy, which needs to be taken for at least 7 days.

Other drugs used for healing peptic ulcers include sucralfate, bismuth compounds and misoprostol.We are not certain how these drugs work but they do seem to increase the resistance of the stomach lining to the damaging effects of acid.