Understanding How Gaviscon Works
Gaviscon provides relief from heartburn and acid reflux through a unique mechanism. Its primary active ingredient, sodium alginate, is derived from natural seaweed [1.3.8]. When it comes into contact with stomach acid, it forms a thick, foam-like physical barrier, or 'raft,' that floats on top of the stomach contents [1.2.2, 1.3.2]. This raft helps prevent stomach acid, as well as other irritants like pepsin and bile, from splashing back up into the esophagus, providing relief that can last up to four hours [1.3.2, 1.3.8]. Some Gaviscon formulations, like Gaviscon Double Action, also contain antacids (calcium carbonate and sodium bicarbonate) that neutralize excess stomach acid for more comprehensive relief [1.3.1, 1.3.8].
A Directly Stronger Version: Gaviscon Advance
For those looking for a more potent version of the same medication, Gaviscon Advance is the answer. It is specifically designed for more persistent and severe symptoms of heartburn and acid reflux [1.3.1]. The key difference is its formulation: Gaviscon Advance contains twice the concentration of sodium alginate compared to Gaviscon Original [1.3.3]. This creates a stronger, more resilient raft, offering relief that can last up to twice as long as some other antacids [1.3.1]. It is also formulated with the lowest sodium content in the Gaviscon range and is considered suitable for use during pregnancy, though consultation with a doctor is always recommended [1.3.3].
Other Classes of Medication for Heartburn
When Gaviscon and its stronger variants are not sufficient, other classes of medications are available, which work in fundamentally different ways. These primarily include Histamine-2 (H2) blockers and Proton Pump Inhibitors (PPIs).
Histamine-2 (H2) Blockers
H2 blockers, such as famotidine (Pepcid AC) and cimetidine (Tagamet HB), work by reducing the amount of acid your stomach produces [1.2.2, 1.5.2]. They do this by blocking histamine, a chemical that signals stomach cells to release acid [1.5.2]. H2 blockers don't act as instantly as antacids but provide longer-lasting relief, often up to 12 hours [1.5.1]. They are available both over-the-counter (OTC) and in stronger prescription-strength versions and are generally recommended for less frequent symptoms [1.4.3, 1.5.1].
Proton Pump Inhibitors (PPIs)
PPIs are generally considered the most effective and strongest class of medication for treating frequent GERD and healing the esophagus [1.2.6, 1.4.6]. This class includes well-known drugs like omeprazole (Prilosec), esomeprazole (Nexium), and lansoprazole (Prevacid) [1.2.2, 1.5.7]. PPIs work by blocking the enzyme system (the 'proton pump') in the stomach wall that produces acid [1.5.7]. This action provides significant and long-lasting acid suppression [1.2.8].
Unlike antacids or even H2 blockers, PPIs are not intended for immediate relief; it can take one to four days for them to reach their full effect [1.2.6, 1.5.7]. They are typically taken daily for a course of 14 days for OTC versions [1.2.6]. Prescription-strength PPIs are used for more chronic cases and can heal esophageal damage (erosive esophagitis) caused by long-term acid exposure [1.5.1, 1.5.5].
Prescription-Only Options
For severe GERD that doesn't respond to other treatments, a doctor might prescribe stronger options:
- Prescription-Strength PPIs and H2 Blockers: These contain higher doses of the active ingredients found in their OTC counterparts [1.5.1, 1.5.5].
- Potassium-Competitive Acid Blockers (P-CABs): This is a newer class of drugs, including vonoprazan (Voquezna), that also inhibits gastric acid but through a different mechanism. They may be recommended if other medications haven't worked [1.5.1, 1.5.3].
- Prokinetics: Medications like metoclopramide (Reglan) work by strengthening the lower esophageal sphincter and helping the stomach empty faster. However, they are used less often due to potential side effects [1.2.2, 1.5.5].
Comparison of Heartburn Medications
| Medication Type | Mechanism of Action | Onset of Relief | Duration | Best For |
|---|---|---|---|---|
| Gaviscon (Alginate) | Forms a physical barrier (raft) over stomach contents [1.3.2]. | Fast | Up to 4 hours [1.3.2] | Mild to moderate, immediate relief. |
| Gaviscon Advance | Forms a stronger, more resilient physical barrier [1.3.3]. | Fast | Up to 4 hours, longer-lasting than Original [1.3.1] | More severe or persistent reflux. |
| Antacids (Tums, Rolaids) | Neutralize existing stomach acid [1.5.1]. | Seconds to minutes [1.2.6] | Short (30-60 minutes) [1.5.2] | Infrequent, mild heartburn. |
| H2 Blockers (Pepcid) | Decrease stomach acid production [1.5.2]. | 15-30 minutes [1.2.6] | Up to 12 hours [1.5.1] | Preventing symptoms, longer relief than antacids. |
| PPIs (Prilosec, Nexium) | Strongly block stomach acid production [1.5.7]. | 1-4 days for full effect [1.5.7] | 24 hours [1.5.2] | Frequent heartburn (2+ days/week), healing esophagus [1.2.6, 1.5.1]. |
| Potassium-Competitive Acid Blockers (P-CABs) | Inhibit gastric acid production [1.5.3]. | Varies | Long-lasting | Severe GERD unresponsive to other treatments [1.5.1]. |
Conclusion: Choosing the Right Treatment
While Gaviscon Advance is a directly stronger version of Gaviscon, the most powerful treatments for severe and chronic acid reflux are from different drug classes entirely. Proton Pump Inhibitors (PPIs) are recognized as the most potent option for reducing stomach acid and allowing the esophagus to heal [1.4.5, 1.5.3]. However, all medications come with potential side effects and considerations for long-term use. OTC PPIs should only be used for a 14-day course up to three times per year [1.6.2]. Persistent symptoms or the need for frequent treatment warrant a discussion with a healthcare provider. They can provide an accurate diagnosis, rule out more serious conditions, and recommend the most appropriate and effective treatment plan.
For more information on GERD and its treatments, you can visit the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
