Should we learn about H2 Blockers for your heartburn and gastritis?

Do you sometimes feel stomach acid increase, heartburn, or stomach discomfort after eating? Or do you have a condition like gastritis? Then you have probably heard of a type of medication called H2 blockers. Today, let's talk about what these H2 blockers are, how they work, and in what situations they are used.

What are H2 blockers (H2 antagonists)?

Simply put, H2 blockers are a type of medication that reduces the amount of acid produced in your stomach. Now you may be wondering what stomach acid is for. Stomach acid is essential for digesting the food we eat. However, problems start when this acid becomes too much. Then the delicate tissues of our digestive system (GI - gastrointestinal tract) can be damaged. This is why symptoms like stomach pain and heartburn occur. Sometimes, eating spicy food can be so difficult that you may think, "Oh, why did I eat that?"

So, if you are someone who suffers from symptoms caused by increased stomach acid, you may want to consider using an H2 blocker.

What conditions are treated with H2 blockers?

H2 blockers are mainly used to treat conditions related to excess stomach acid production. But one thing to keep in mind: With continued use of these medications, their effectiveness may gradually decrease over time.

If you have a chronic, long-term condition involving excess stomach acid, you may want to consider a type of medication called a proton pump inhibitor (PPI) . Although PPIs don't work as quickly as H2 blockers, they also reduce stomach acid production and can be used for longer periods of time than H2 blockers. PPIs are a type of medication that is more powerful at controlling acid than H2 blockers.

Let's take a look at some of the main conditions treated with H2 blockers:

Stomach ulcers and duodenal ulcers

When stomach acid becomes too high, it can erode the stomach lining and cause ulcers. H2 blockers reduce stomach acid production, giving these ulcers time to heal.

Also, stomach acid can sometimes travel up into the first part of our small intestine (duodenum) and cause ulcers there. We call these duodenal ulcers . Although PPIs are actually the most effective treatment for this, H2 blockers can also treat this condition. The US Food and Drug Administration (FDA) has approved H2 blockers for short-term maintenance treatment to prevent new ulcers from forming. Your doctor can talk to you about the right treatment and maintenance regimen for you.

Acid reflux and GERD

This is a problem that many people have. Acid reflux is when acid from the stomach flows back up into the esophagus (food pipe) and into the throat. This is what causes heartburn. If this condition continues, it can lead to esophagitis. An H2 blocker can help with occasional acid reflux. But if you have long-term acid reflux, or GERD (Gastroesophageal Reflux Disease) , you may be better off using a PPI.

Zollinger-Ellison syndrome

This is a very rare condition. It occurs when certain tumors in our bodies cause our stomachs to produce too much acid. H2 blockers can help by blocking the production of stomach acid. However, in this case, your doctor will likely prescribe a PPI.

Symptoms relieved by H2 blockers

These medications can provide relief from the following symptoms:

• Bloating, indigestion
• Stomach pain
• Heartburn and reflux
• Nausea and vomiting
• Sour stomach, sour taste in the throat

How do H2 blockers work?

Another name for H2 blockers is histamine-2 (H2) antagonists . This name gives us a little idea of ​​how these drugs work. You may have learned about the role of an 'antagonist' in English class when you were in school. In a sentence, an antagonist is something that causes an obstruction. In the same way, H2 antagonists block the production of stomach acid.

Think of it this way. After you eat a meal, your body releases a chemical called H2. This H2 goes and attaches to specific sites (H2 receptors) on the cells in the walls of your stomach. This attachment is what causes your stomach to secrete acid.

When you take an H2 antagonist, or H2 blocker, the drug goes to those H2 receptors before H2 can bind to them. Simply put, H2 blockers "block" H2 from binding to those receptors. This reduces the production of acid in the stomach.

This won't interfere with your digestive process. But it will reduce the amount of extra acid that causes those painful symptoms. Got it?

What are the types of H2 blockers? (Medicines available on the market)

There are several types of H2 blockers. Some you can buy over-the-counter (OTC) at a pharmacy without a prescription (Rx). Some require a prescription from a doctor. This varies depending on the type of medication and the dosage.

The types of H2 blockers currently available are:

• Cimetidine ( brand name, for example, Tagamet®) - This is available both OTC and Rx.
• Famotidine (brand name, for example, Pepcid®) - This is also available both OTC and Rx.
• Nizatidine (brand name Axid®, for example) - This can only be obtained with an Rx.

You may have heard of Ranitidine ( known by the brand name Zantac®). It was the first H2 blocker approved by the FDA in 1983. However, in April 2020, the FDA ordered manufacturers to remove Ranitidine from the market. The reason for this was that FDA tests found that when Ranitidine was stored for a long time, levels of a possible carcinogen (nitrosodimethylamine, or NDMA) increased to unsafe levels. Researchers also found that NDMA levels increased when Ranitidine was stored at high temperatures.

How to use this medicine?

Most H2 blockers come in the form of pills or capsules that you take by mouth. Sometimes they also come in a powder that you can mix with liquid and drink for people who have trouble swallowing pills.

Some H2 blockers can also be given intravenously (IV) , especially if you are hospitalized and cannot take the medication by mouth.

What is the best time to take an H2 blocker?

If you know you're going to eat something that you don't like, like a spicy meal, it's a good idea to take an H2 blocker about 30 to 60 minutes before you eat it. That way, the medication has time to start working. It's okay to take it after you've finished eating, but it can take up to an hour for your symptoms to subside.

As a short-term treatment for a condition such as a stomach ulcer, your doctor may tell you to take this medicine as follows:

• Once a day, before going to bed at night.
• Or once in the morning and once at night.

The most important thing is that if you need to use an H2 blocker for more than two weeks to control your symptoms, you should definitely see a doctor. It's not a good idea to rely on H2 blockers for a long time without talking to a doctor.

How long does it take for H2 blockers to work? How is it different from other medications?

It usually takes about an hour to feel relief from symptoms after taking an H2 blocker. The effects usually last from four to ten hours . This fast-acting action makes it a good choice if you need immediate relief or if you only have occasional heartburn.

If you need even faster relief, you can try an antacid . Antacids neutralize the acid in your stomach. They will start working faster than an H2 blocker, but their effects won't last as long as an H2 blocker.

If your symptoms are long-lasting, especially if an H2 blocker doesn't provide enough relief, you may need to take a PPI. A PPI can take one to four days to take full effect, but it lasts much longer than an H2 blocker.

Do H2 blockers have side effects?

H2 blockers provide relief with a low risk of side effects. However, like any medication, minor side effects can occur.

Common side effects

• Stomach pain
• Muscle pain
• Constipation
• Diarrhea (bloating)
• Dry mouth
• Tiredness
• Headache

Things to pay special attention to

Although very rare, H2 blockers can cause neurological symptoms (e.g., confusion, slurred speech) in some high-risk groups. You are more likely to experience these symptoms if you are over 50 and have reduced kidney or liver function . However, these symptoms usually go away within a few days after stopping the medication.

Can there be problems with other medications?

Some H2 blockers (for example, cimetidine) can prevent some other medications you are taking from working properly. For example, cimetidine can reduce the effectiveness of some SSRIs (a type of medication used to treat mental illnesses such as depression) and warfarin (a medication that prevents blood clots).

Therefore, before starting a new medication, it is very important to talk to your doctor to find out if there are any adverse interactions with the medications you are already taking.

Is it safe to use H2 blockers during pregnancy and breastfeeding?

More research is needed to determine the safety of using H2 blockers during pregnancy, but researchers do know that the drug passes into breast milk .

If you are taking an H2 blocker and are pregnant, be sure to talk to your doctor. Ask him/her if it is safe to take this medication during pregnancy or while breastfeeding.

When do you need to see a doctor?

As we mentioned earlier, if you have to use H2 blockers for more than two weeks to control your symptoms, you should definitely see a doctor. It's important to find out exactly what's causing your symptoms. You may need a longer-term solution, like a PPI.

Also, tell your doctor if you have any adverse reactions to the medication or notice any side effects. Your dosage may need to be changed or you may need to switch to a different medication.

What is the safest H2 blocker? What is the best for GERD?

FDA-approved H2 blockers are largely similar in terms of their safety and effectiveness.

However, if you are taking other medications and are considering using an H2 blocker, it is best to talk to your doctor. It is important to choose a medication that will not interfere with the effectiveness of the medications you are already taking.

For GERD, any H2 blocker can help relieve acid reflux symptoms. However, if your acid reflux is chronic (as in GERD), it may be better to skip H2 blockers altogether and opt for a PPI. Talk to your doctor about this as well.

Finally, things to remember (Take-Home Message)

Okay, so we talked a lot about H2 blockers today, right?

H2 blockers, antacids, and PPIs are all used to treat conditions caused by excess stomach acid. Sometimes, with so many options, it can be confusing to know which one to choose.

Think about it this way: If you're looking for short-term relief that lasts a few hours, H2 blockers may be the best option for you. Especially if you know you're likely to get heartburn after eating something spicy, it's a good idea to take an H2 blocker beforehand.

Remember, if you have any further questions about this medication, don't be afraid to ask your doctor. It's very important to be informed about your health!

` H2 blockers, gastritis, stomach inflammation, stomach acid, chest inflammation, stomach ulcers, Sinhala medical articles