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If you have had any sort of invasive procedure or diagnostic examination done, you will know that a common question asked is “have you taken any aspirin in the past two weeks?”. People who have had major or minor surgery and are taking aspirin will be asked by their doctors to stop taking it two weeks prior to the procedure. This is because aspirin is an anti-platelet drug, meaning it is a drug that prevents blood from clotting. If you have a medical condition that makes you prone to blood clots like cardiac or cerebrovascular disease, aspirin is a very important drug that you have to take. However, this drug is dangerous if you are being operated on or undergoing an invasive procedure like a CT scan — it can cause you to bleed out.
So what does aspirin have to do with antacids? The bottom line: Many over-the-counter antacids contain aspirin. Popping antacids every time you feel “heartburn” may seem like it won’t be harmful in the long run but it is. Aspirin-containing antacids can damage the sensitive inner lining of the stomach, which can cause the small blood vessels to rupture, leading to bleeding and ulceration. [1]
The Food and Drug Administration has released an FDA Drug Safety Communication that warns the public of “serious bleeding risk” from taking over-the-counter antacids. While these antacid tablets contain the fine print on their labels regarding bleeding risk, it is often advice that goes unheeded or unread. The FDA still receives a significant number of reports on the safety issues of taking antacids, which called for the release of their safety announcement last year, in 2016. Consumers should always read the Drug Facts label and avoid aspirin-containing products if they are at risk for bleeding. [2]
The FDA cites the following risk factors for bleeding: (1) age of 60 years or older, (2) personal history of stomach ulcers or bleeding, (3) taking other blood thinners and steroid medication, (4) taking NSAIDs like ibuprofen or naproxen, and (5) drinking three or more alcoholic drinks in a day. [2]
In an updated set of guidelines for GERD treatment published in 2005 in the American Journal of Gastroenterology, self-medicating with antacids should not last more than two weeks because of the increased risk for complications, bleeding included. This guideline is still used today, not just in the management of GERD, but stomach problems that call for taking antacids. [3]
Aside from dangerous bleeding, abusing antacids can also cause the following side effects: [4]
• Persistent diarrhea (for antacids with magnesium)
• Severe constipation (for antacids with aluminum and calcium)
• Kidney stones (rare, but happens with antacids with calcium)
• Osteoporosis (for antacids with magnesium, which can cause bone loss)
Instead of heading to the drug store to manage an upset stomach or heartburn, remember these natural antacids instead. [5]
• Apple cider vinegar! Heartburn can be caused by not having enough acid in your stomach, so supplementing your diet with one tablespoon of ACV in one glass of water once a day can help.
• Aloe juice. Aloe is known to help with burns and inflammation because of its soothing properties.
• Ginger tea or juice. Ginger ale is very popular in managing the symptoms of an upset stomach. You can take it as a juice or tea, which ever suits your palate more.
• Slippery elm. The bark from the slippery elm tree can be brewed into a tea, which have been used for centuries with manage gastrointestinal problems.
References:
[1] US Food and Drug Administration (2016). Code of Federal Regulations Title 21. https://accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=331
[2] US Food and Drug Administration (2016). FDA Drug Safety Communication: FDA warns about serious bleeding risk with over-the-counter antacid products containing aspirin. https://www.fda.gov/Drugs/DrugSafety/ucm504328.htm
[3] Smith, L. (2005). Updated ACG Guidelines for Diagnosis and Treatment of GERD. https://aafp.org/afp/2005/0615/p2376.html
[4] US National Library of Medicine. Taking antacids. https://medlineplus.gov/ency/patientinstructions/000198.htm
[5] Mercola, J. (2014). 15 Natural Remedies for the Treatment of Acid Reflux and Ulcers. https://articles.mercola.com/sites/articles/archive/2014/04/28/acid-reflux-ulcer-treatment.aspx
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