Why antacids are worsening your heartburn, giving you a runny stomach and other side effects

Relying too much on these over-the-counter (OTC) medications without addressing the root cause of acid reflux or indigestion can result in unintended side effects, some of which may be serious.

Nutrient Deficiencies and Malabsorption

One of the most significant concerns with long-term antacid use is its impact on nutrient absorption. The stomach needs an acidic environment to properly break down food and absorb essential nutrients like calcium, magnesium and vitamin B12. Frequent use of antacids, especially proton pump inhibitors (PPIs) or H2 blockers, reduces stomach acid, leading to poor absorption of these nutrients. Over time, this can result in deficiencies, increasing the risk of osteoporosis (due to calcium depletion), muscle weakness (from magnesium deficiency), and neurological issues such as memory problems and nerve damage (from vitamin B12 deficiency).

Rebound Acid Hypersecretion

When antacids suppress stomach acid for an extended period, the body compensates by increasing acid production once the medication is discontinued. This can lead to more severe heartburn and acid reflux symptoms, trapping individuals in a cycle of antacid dependence.

Increased risk of kidney disease

Research has suggested a link between long-term PPI use and an increased risk of kidney disease, kidney inflammation and, in some cases, long-term kidney damage. Since kidney disease can progress silently without symptoms until it reaches an advanced stage, individuals who take antacids regularly may unknowingly be putting their kidney health at risk.

Potential for Cardiovascular Problems

Some studies have suggested that long-term PPI use may be associated with an increased risk of heart disease. The exact mechanism is not entirely understood, but researchers believe that these medications may affect blood vessel function and contribute to higher cardiovascular risks over time. People with heart conditions should exercise caution.

Risk of Bone Fractures

Since antacids interfere with calcium absorption, prolonged use—especially of PPIs—has been linked to an increased risk of fractures, particularly in older adults. Studies have shown that individuals taking high doses of PPIs for extended periods have a greater likelihood of suffering hip, wrist, or spine fractures.

Natural remedies like consuming smaller meals, avoiding trigger foods (spicy, fried, and acidic items), staying upright after eating, and maintaining a healthy weight can help reduce reliance on antacids. For chronic acid reflux, consult a doctor for alternative treatments or lifestyle modifications.

(Dr Chatterjee is internal medicine specialist at Apollo Hospital, Delhi)