Do antacids cause constipation

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Do Antacids Cause Constipation?

Introduction to Antacids and Their Uses

Antacids are commonly used to treat various gastric conditions such as non-ulcer dyspepsia, duodenal ulcers, gastric ulcers, stress gastritis, gastroesophageal reflux disease (GERD), and other related conditions. They work by neutralizing stomach acid, thereby providing symptomatic relief from hyperacidity and associated discomforts .

Mechanisms of Antacids and Their Effects on Intestinal Motility

Aluminum Hydroxide and Constipation

One of the primary components of many antacids is aluminum hydroxide. Clinical observations have shown that aluminum hydroxide can lead to constipation. This is due to its inhibitory effects on the motor activity of the stomach and intestines. Aluminum ions affect the smooth muscle of the gut and the enteric nervous system, leading to reduced bowel movements 13.

Magnesium Hydroxide and Diarrhea

In contrast, magnesium hydroxide, another common ingredient in antacids, tends to have the opposite effect by stimulating muscle contractions in the gut, which can lead to diarrhea. This is due to its osmotic-secretory effects, which increase water content in the intestines .

Combined Effects in Antacid Formulations

Many antacid formulations, such as Digene, combine aluminum hydroxide and magnesium hydroxide to balance these opposing effects. This combination aims to provide effective acid neutralization while minimizing the risk of either constipation or diarrhea .

Clinical Recommendations for Managing Constipation

For patients who require chronic use of aluminum hydroxide-containing antacids, it is recommended to take preventive measures against constipation. These measures include increasing fluid intake, using laxatives, and, if renal function permits, alternating with magnesium-containing antacids to reduce the risk of fecal impaction .

Conclusion

In summary, while antacids are effective in treating various gastric conditions, they can cause disturbances in gut motility. Specifically, aluminum-containing antacids are associated with constipation due to their inhibitory effects on intestinal motility. To mitigate this side effect, a combination of aluminum and magnesium hydroxide is often used, and additional preventive measures are recommended for patients on long-term antacid therapy.

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Most relevant research papers on this topic

Clinical experience in prevention of candidiasis by nystatin in children with acute lymphocytic leukemia.

Chronic use of aluminum hydroxide, along with constipation, may increase the risk of bowel obstruction.

1978·

43citations

·U. Carpentieri et al.

An expert opinion on antacids: A review of its pharmacological properties and therapeutic efficacy

Antacids effectively treat acidity and related conditions by neutralizing gastric acid, restoring pH balance, and increasing prostaglandin and bicarbonate secretion.

Literature ReviewRigorous Journal

2022·

0citations

·B. Shetty et al.

[Effect of antacids on intestinal motility].

Highdose antacid regimens can cause both diarrhea and constipation due to the cations in the antacids, with aluminum causing constipation and magnesium inducing diarrhea.

1983·

3citations

·M. Wienbeck et al.

Management of antacid impactions in hemodialysis and renal transplant patients.

Antacid impactions can cause intestinal obstruction in renal transplant and hemodialysis patients, necessitating aggressive medical and surgical management.

Case Report

1980·

17citations

·J. Welch et al.

Antacids Revisited

Antacids are still useful for stress gastritis and non-ulcer dyspepsia, but their widespread use may decline due to newer, more effective agents.

1999·

65citations

·P. Maton et al.

Effect of calcium carbonate and aluminum hydroxide on human intestinal function

Calcium carbonate and aluminum hydroxide both increase fecal output, reducing fecal fat and potentially lowering blood lipids and improving colonic mucosa.

RCT

1988·

26citations

·D. Saunders et al.

Control of Constipation in Patients Receiving CHOP or CHOP-Like Chemotherapy Regimens for Non-Hodgkin's Lymphoma.

Preventing constipation in patients receiving CHOP chemotherapy is crucial, but avoid negative drug interactions between magnesium oxide and antacids.

Observational Study

2017·

8citations

·H. Hayashi et al.

Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use.

Antacids are still useful for stress gastritis and non-ulcer dyspepsia, but their wide-spread use may decline due to newer, more effective agents, and clinicians should be aware of potential drug interactions and adverse effects.

Literature ReviewHighly Cited

1999·

81citations

·P. Maton et al.

[Stool behavior following the administration of antacids].

High magnesium content in antacids can cause diarrhea in ulcus-patients, while the triple-combination (Al, Mg, Ca) shows neutral stool behavior and serum electrolytes remain within normal range.

Non-RCT

1984·

0citations

·C. Kori-lindner

Healing of benign gastric ulcer with low-dose antacids and fiber diet.

Low-dose antacids and a high-fiber diet effectively heal benign gastric ulcers and relieve symptoms, but dietary treatment has no significant impact on ulcer healing or symptoms.

RCT

1986·

53citations

·A. Rydning et al.

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