There are several medications that you can use. I know you mentioned that you tried some of these, but I'll be complete.
First line therapy for indigestion / acid reflux are antacids. These medications directly neutralize acid in the stomach. The provide the quickest relief, but also last the shortest. Examples are Tums, Mylanta, Maalox, etc. There are also similar product that have alginic acid in them, like Gaviscon. These don't actually neutralize the acid themselves but rather make a foamy barrier that floats on the stomach contents. When the stomach refluxes its contents, it tends to be this neutral foam rather than the acidic stew.
Second line are the H2 antagonists. These are drugs like Zantac, Pepcid, and Tagamet. There are receptors in the stomach that trigger the production of acid. H2 antagonists block these receptors. Less signal is recieved, so less acid is produced. These take a little longer to work, maybe a half-hour, but last longer, perhaps 4-8 hrs depending on the patient. A problem with these drugs is that they tend to work optimally only for about two weeks. Then, the stomach tends to adapt to the interference with the acid producing signal.
Lastly we have the proton pump inhibitors. (PPI) These drugs are really quite slick. What they do is they permanently disable the acid pumps in the cells lining the stomach. Eventually, the stomach regenerates them, but it takes a couple of days. Now, these drugs only work when the stomach is actively secreting acid. The best time to take these drugs is usually a half-hour before a meal. That gives time for the drug to accumulate in the stomach tissue before the pumps are activated by eating.
What causes acid reflux? When the pressure below the pyloic sphincter is greater than the pressure above it and the sphincter is incompetent and cant withstand the pressure. This can come from having too big a belly. Many patients find relief from simply losing weight. This can take a while, however. Many foods can weaken the sphincter, like spicy peppers and caffiene. Alchohol increases stomach acid production.
If you have lost some weight and changed your diet as best you can, then drugs can help a lot. For sporadic bouts of acid reflux, antacids and H2 antagonist usually work just fine. For more serious problems, taking a PPI once daily works well, although a few patients may need to take it twice a day. You can always take the PPI for control and an antacid as needed. The three types of medications stack very nicely.
Remember, though. You don't want to
completely turn off your stomach's acid production. That is how your body defends itself from bacteria hitching a ride in on what you eat. That can cause problems.
Lastly, there are some disorders that require higher doses of medications or even surgery. This can be very serious problems. Usually this involves a physician using an endoscope to peek down your throat to see just what kind of damage you are dealing with. Often medications can control the situation, but surgery to repair the damage might be appropriate. At this point, we travel beyond my scope of practice.
(Oh, there's also metocloperimide (Reglan) which quickens the stomach emptying. We try to avoid that, however, because of the side effects and other medication interactions.)
Baron Opal, Pharm.D.