Almost on a daily basis, pharmacists come into contact with someone with a stomach ailment. It is important to find out what caused the patient's stomach upset and then to offer tips on how to treat it (Table 1). Show Stomach Pain or Cramping Gas, indigestion, or perhaps gastritis (an inflammation of the lining of the stomach) can cause abdominal pain. The problem can result from overeating, or it can be a reaction to alcohol, caffeine, or even medication. Diet restrictions, such as taking only bland foods and clear liquids, could relieve the symptoms. Antacids, which are neutralizing agents, are often used to relieve the symptoms of heartburn (Table 2). For instance, the ingredient in Pepto-Bismol (bismuth subsalicylate) coats the esophagus, acts as a barrier to reflux, and alleviates pain and other symptoms. Pepto-Bismol is indicated for indigestion, heartburn, upset stomach, nausea, and diarrhea. Children with flu-like symptoms should not take it, because it can lead to Reye's syndrome. Flatulence (Intestinal Gas) Gas is a natural part of the digestive process. It can be caused by beans and some fruits and other vegetables. Natural products to treat gas include chamomile and peppermint. OTC formulations contain simethicone, a defoaming agent. In addition to simethicone, Flatulex, for example, contains activated charcoal, which absorbs substances that may cause gas and also relieves gas pain and bloating. New formulations of antacids and simethicone are now available (Table 3). Beano, another product approved for treating flatulence, comes from the Aspergillus niger mold and is a solution of an enzyme known as alpha-Galactosidase. This enzyme breaks down oligosaccharides (which high-fiber foods contain) and can be a prophylactic treatment for gas caused by high-fiber foods. Diarrhea Diarrhea can occur as a result of a stomach virus, food poisoning, stress, and certain medications, and it can lead to dehydration. Patients should be counseled to drink plenty of clear fluids that do not contain too much sugar. In addition to diet restrictions, Pedialyte may be recommended for electrolyte loss (Table 4). If diarrhea lasts longer than 48 hours, a physician should be consulted. Heartburn Whereas many factors contribute to heartburn, it generally is caused by a poorly functioning lower esophageal sphincter, which allows the contents of the stomach to back up into the esophagus. Pregnancy, obesity, smoking, caffeine, alcohol, chocolate, and spicy foods may cause or aggravate heartburn. Antacids are first-line therapy (Table 2). Taken before a meal, they provide relief for about 40 to 60 minutes, and up to 3 hours if taken after a meal. Frequent use of antacids containing aluminum, however, can cause constipation, and those containing magnesium can cause diarrhea. Antacids can affect certain medications, so it is advisable to separate doses by at least 2 hours. Gaviscon, containing alginic acid as well as sodium bicarbonate, aluminum, and magnesium, coats the stomach. Tablets should be chewed and taken with plenty of water. Pepcid Complete is a combination of famotidine (a histamine2-receptor antagonist [H2RA]) and magnesium hydroxide and calcium carbonate. It offers the advantage of prompt relief from the antacids and acid reduction from the H2RA. Experts have found that this combination offers more sustained relief. Proton pump inhibitors (PPIs) have a longer duration of action than H2RAs. Prilosec OTC, a 20-mg tablet, is the only PPI currently available over the counter. PPIs may interact with certain drugs, such as warfarin and diazepam, however. Dr. Pelegrin is the pharmacy manager of a Publix Pharmacy in Miami, Fla. When you have a headache or an aching back, you may reach for an over-the-counter pain reliever. Or maybe you take medication to
help with a long-term condition. Most of the time, medicines make you feel better. But some can upset your stomach or cause other trouble with your digestive system. If you have issues like this, talk with your doctor. They might suggest something
else or suggest you change your dose. Aspirin can affect the lining of your stomach and cause belly pain and other problems. Other
pain relievers, like ibuprofen and naproxen, can lead to heartburn, irritation,
and other stomach trouble, too. If that happens, you might try taking these with food or with a drug that treats heartburn. Doctors use these to clear up infections caused by bacteria, but some people have
nausea, diarrhea, and gas when they take them. A mix of bacteria helps your body
break down food you eat and turn it into energy. Antibiotics can kill the “good” bacteria in your body, along with the “bad,” and upset the healthy balance that makes your digestive system work like it should. Foods that have “good”
bacteria known as probiotics -- like yogurt that says “active and live cultures” on the label -- may help keep things in check. And be sure to follow any directions your doctor gives you about taking them on an empty or full stomach. If your
blood has high levels of cholesterol, which can cause heart problems, your doctor might recommend medicine to bring those down. Some of those can
affect your digestion and cause problems like gas, constipation, or diarrhea. It’s rare, but cholesterol drugs
known as statins can cause problems with your liver, too. Powerful
opioid painkillers, like oxycodone or hydrocodone, can make you feel nauseous or have
constipation, belly cramps, or bloating. Most over-the-counter laxatives don’t help with this, but your doctor may be able to give you something that will. Iron SupplementsIron helps your blood carry oxygen to your cells. If you don’t have enough, you can have a condition called iron-deficiency anemia. It’s usually treated with supplements, but those can cause stomach pain and constipation and irritate your esophagus -- the tube that connects your mouth to your stomach. ChemotherapyNausea, vomiting, and diarrhea are among the most common side effects of the powerful drugs used to treat cancer. Your doctor can give you medicine to ease those effects. Changes to what you eat -- like staying away from fried or spicy foods -- can help, too. |
What medication is good for upset stomach
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