Reflux has such wide-ranging symptoms, including heartburn, regurgitation, hoarseness, voice problems, chronic coughing and throat clearing, that many people take reflux medication before getting diagnosed.
In order to answer these concerns, let’s take a look at the different re
medies currently used for reflux.
Antacids are drugs intended to provide immediate, short term relief for symptoms of heartburn and dyspepsia by neutralising the hydrochloric acid your stomach uses to aid digestion. Antacids usually come as chewable tablets or liquids, with common brands including Tums, Alka-Seltzer, and Rennie.
Raft-forming or alginate suspension products, such as Gaviscon tablets and suspension, produce a temporary physical barrier (known as a raft) that blocks stomach contents including pepsin and bile acids from backing up into the oesophagus and your airways.
H2 receptor antagonists or H2 blockers, such as Ranitidine, come in liquid and tablet form. The H stands for histamine – a chemical naturally produced by the body which stimulates the production of acid in the stomach. These drugs block the action of histamine.
Proton Pump Inhibitors (PPIs), the most commonly prescribed medication for reflux, work by blocking the site of acid production in the stomach cells – the proton pump. Proton Pump Inhibitors are more effective at suppressing acid secretion and work over a longer period than H2 receptor antagonists.
Diet and lifestyle changes – many people use alternative methods such as drinking alkaline water, following special reflux diets and making lifestyle modifications.
Peptest and medication: our recommendations
We recommend that you stop taking antacids and raft-forming/ alginate suspensions, stop drinking alkaline water and do not start diet and lifestyle changes 48 hours prior to providing samples for Peptest analysis. This is because they may prevent reflux or break down pepsin which will influence the outcome of the test.
It is not necessary to stop PPI or H2 receptor antagonist therapy as Peptest will still detect any refluxed pepsin in the presence of these. This is because they do not prevent reflux from occurring.
We recommend that you always provide samples on a day that you are experiencing symptoms and it is important that you do not alter your behaviour on the day that you provide samples. This means you should eat your normal diet and perform normal everyday activities.
Peptest will measure the concentration of pepsin in your saliva sample – once you have your baseline reading of pepsin levels you can re-introduce your medications or perhaps undergo lifestyle modifications and monitor any symptom relief before testing again using Peptest.
I currently drink 9.5 Alkaline water and no I will have to get off the water but can I drink spring water 48 hrs before pep test. I’m also a taking 20 mg of omeprazole a day can I continue taking that?
Dear Sara,
Thank you for your question.
You can continue to take omeprazole as Peptest will still detect pepsin in the presence of PPI or H2 receptor antagonist therapy if pepsin is being refluxed.
Many thanks.
Re: the article comment above about alkaline water.
In the UK I believe there is no widely/easily available ‘alkaline water’ that denatures pepsin. At best alkaline water is 7.8ph and although this is very good (and a healthy choice!) it probably won’t be high enough to ‘destroy’ the refluxed pepsin, from the papers I have read – it needs to be 8+ph.
There are a couple of excellent Icelandic brands which supply privately via mail order but unless alkaline water of 8+ph is more readily available in supermarkets, etc it is almost impossible to find easily without great cost.
I emailed one of the supermarkets to see if they will stock either brand and they did pass it to their marketing dept. So fingers crossed.
Update: I have found out recently that Tesco stocks a brand of alkaline water called Saka Natural Mineral Water, which claims to be 8.2PH, which if true should be excellent for anyone in the UK trying to source a water of the type that is said to denature pepsin. It is priced at £2.00 for a six pack of 1.5 litre bottles.
Thanks.
I suggest you look up ‘Alkalife’ – they sell alkaline booster drops that when added to water increase the pH to 8 – 10 (depending on how much you add). I have ordered Alkalife drops (£20 for 3 months worth) and a digital pH meter (£6 from a different supplier). I’m waiting them to arrive and will post an update after usage.