Depending on the cause of the stomach pain, different drugs are used in medicine. These include antispasmodic drugs (spasmolytics), normal painkillers (analgesics) and drugs that reduce the acidity of the stomach. In addition to medications, one can also aim to change one’s lifestyle to relieve the symptoms. For example by changing your eating habits or by giving up cigarettes and alcohol. Also “home remedies” such as heat and herbal teas (chamomile, balm, peppermint) provide an improvement and are initially preferred.
Drugs
A variety of over-the-counter drugs can be used in the treatment of stomach pain. Stomach pain is an everyday problem for many people. You do not always have to point out a serious underlying disease.
Stomach pain is particularly common after eating, as it causes irritation of the stomach, intestine or esophagus. This is usually temporary, so that the pain can be bridged with over-the-counter medication. Analgesics (painkillers) are a remedy of choice for many types of pain.
Analgesics with a particularly strong effect, for example the “opioids“, are mostly available only on prescription. The group of NSAIDs, to which ibuprofen, Aspirin®, naproxen or diclofenac belong, can be obtained without a prescription in any pharmacy. Paracetamol is also a highly effective painkiller for mild to moderate pain.
However, the side effects of NSAIDs can themselves cause stomach problems. They lead to increased acidity in the stomach and can irritate the mucous membranes of the stomach and esophagus. If the pain is caused by stomach acid, antacids, antihistamines or proton pump inhibitors can relieve the symptoms.
Most of these can also be obtained without a prescription from a pharmacy. If stomach pain occurs as a result of stomach cramps, antispasmodic drugs can be prescribed, the so-called spasmolytics. Stomach cramps are characterized by an undulating course and occur at intervals.
Spasmolytic drugs are divided into different substance classes, which have in common that they loosen the tension of the smooth muscles. Spasmolytics include parasympatholytics, which act antagonistically to the normal action of the parasympathetic nervous system. The drugs block the receptors for the parasympathetic messenger acetylcholine, which reduces the contractility of the smooth muscles lining the gastrointestinal tract.
Parasympatholytics include drugs such as: Side effects include an increased heart rate and, under certain circumstances, angina pectoris attacks due to inhibition of the parasympathetic nervous system. In addition, intestinal emptying may be delayed, the mouth may become dry and there may be tiredness or restlessness.
- Atropine
- Butylscopolamine (Trade name: Buscopan®)
- Ipratropium
Sympathomimetics represent another class of substances.
These activate so-called adrenoreceptors, which activate the sympathetic nervous system. In the sympathetic nervous system, we distinguish between alpha and beta receptors. Only the beta-receptors lead to a relaxation of the smooth muscles, which is why only substances that selectively act on the beta-receptors are chosen as spasmolytics.
Examples of these beta-sympathomimetics are Both parasympatholytics and beta-sympathomimetics act on the receptors of the nervous system, they are called neurotrophic spasmolytics. Here, the side effects can include a slight tremor, as well as an increased heart rate and blood pressure. In addition to these, there are substances that act directly on the smooth muscles and trigger relaxation, the so-called myotropic spasmolytics.
These include papaverine, as well as organic nitrates and calcium antagonists (e.g. nifedipine).
- Fenoterol
- Salbutamol
- Terbuatlin
For the treatment of pain, drugs such as Paracetamol is one of the most frequently used painkillers alongside ASA and ibuprofen. It is used for mild and moderate pain.
Paracetamol belongs to the group of cyclooxygenase inhibitors and the group of non-opioid analgesics. It also has a fever-reducing effect. Due to its good tolerability it is often used in children.
Paracetamol inhibits the enzyme cyclooxygenase 2, which is activated when cells are damaged and produces prostaglandins that promote inflammation and also increase pain.When taking the product, it is important to ensure that the maximum daily dose is not exceeded, as this can lead to life-threatening liver damage. Paracetamol has very few side effects. Very rarely, if taken correctly, side effects such as a disturbance in blood formation, allergic reactions, abdominal pain, nausea and an increase in liver values may occur.
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) and, like paracetamol, a non-opioid painkiller. It is also used for mild to moderate pain, but unlike paracetamol it is also used in the context of inflammation, as it has an anti-inflammatory effect in addition to an analgesic and low fever-lowering effect. Ibuprofen also inhibits the enzyme cyclooxygenase, but like the other NSAIDs it inhibits cyclooxygenases 1 and 2, which also leads to a suppressed formation of prostaglandins that promote inflammation, cause pain and increase fever.
Ibuprofen causes more side effects than paracetamol. Frequently, gastrointestinal complaints such as heartburn, abdominal pain, constipation, nausea and vomiting, diarrhea, and slight bleeding in the gastrointestinal tract occur.
- Paracetamol
- Ibuprofen
- Naproxen
To combat acid-induced stomach pain, drugs that increase the acidic pH value in the stomach can also be used.
The so-called antacids are suitable for this purpose. Antacids are weak bases or the salt of a weak acid, so that the stomach acid is buffered and the environment in the stomach becomes less acidic. Aluminium and magnesium hydroxide gels and compounds of calcium and magnesium carbonate are used.
They are well tolerated and are hardly absorbed, so that they only work in the stomach. Due to the development of proton pump inhibitors and H2 antagonists, antacids are now used less frequently, as they directly inhibit the production of gastric acid and thus act better and longer. Also known as H2 antagonists, they inhibit the secretion of gastric acid.
Antihistamines bind H2 receptors so that histamine can no longer be absorbed. Histamine normally promotes the secretion of stomach acid so that the pH in the stomach shifts towards more alkaline levels. Antihistamines inhibit gastric acid secretion less than comparable proton pump inhibitors. Antihistamines include cimetidine and ranitidine. Side effects such as headaches, fatigue, dizziness, diarrhea and constipation rarely occur.
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