What is the right time to take stomach medicine?

  The commonly referred to “stomach medicine” includes the following categories, with different mechanisms of action, and should be taken at different times.  Antacids: are weak alkaline inorganic compounds that neutralize stomach acid and quickly relieve heartburn, pain and other symptoms caused by stomach acid. The common ones are magnesium aluminum carbonate (Daxi), calcium carbonate, aluminum hydroxide and magnesium trisilicate compound (Gastrodia), etc.. These drugs can be taken before or after meals (1-2 hours) and at bedtime, and can also be taken during heartburn and stomach pain attacks. However, care should be taken to avoid taking them immediately after meals, as they will be emptied from the stomach along with food and lose their effect. Liu Kui-Liang, Department of Gastroenterology, Beijing Saitan Hospital, Capital Medical University Inhibits the secretion of gastric acid, thereby weakening the effect of gastric acid on the gastric mucosa. Two types of drugs are commonly used, including histamine receptor antagonists, such as cimetidine, ranitidine, famotidine, etc., and proton pump inhibitors with stronger acid-suppressing effects, such as omeprazole (Loxac), lansoprazole, rabeprazole (Polite), etc. The former class of drugs is mostly taken after breakfast or dinner or before bedtime. The latter category of drugs should be taken before breakfast daily, or when taken twice daily, should be taken on an empty stomach before breakfast or dinner. Pills should be swallowed whole and should not be chewed or crushed.  Gastric mucosal protective agents: There are two main categories commonly used. One class of drugs, such as aluminum thioglycollate, aluminum phosphate, bismuth potassium citrate, etc., need to act directly with the stomach wall to form a protective film at the ulcer or inflammation site so as to play a barrier role, and therefore usually need to be taken one hour before meals or on an empty stomach to avoid food impeding the contact between the drug and the stomach wall. Another class of drugs, such as gemfacate (Huizhong), is absorbed through the gastrointestinal tract and protects the gastric mucosa by promoting the secretion of relevant chemicals from the epithelial cells of the gastric mucosa without direct contact with the gastric wall. It is also better to take it after meals because it is fat-soluble and can be better absorbed by the gastrointestinal tract when dissolved in fat.  Gastrointestinal motility drugs: a class of drugs to increase gastrointestinal motility, commonly used, including domperidone (morpholine), mosapride, etc., is best taken 15-30 minutes before meals, so that the full effect of the meal.  Digestive drugs: drugs that promote gastrointestinal digestion of food, most of these drugs are themselves the main components of normal digestive juices, such as pepsin, pancreatic enzymes, etc. At present, the multi enzyme tablets, compound digestive enzymes (Daji), compound Azinomide (Ute), compound Kampeshen tablets, etc. are all compound preparations of various digestive enzymes that are commonly used in clinical practice. They can be taken 15-30 minutes before or during or immediately after meals to promote food digestion and relieve abdominal distension, loss of appetite and other indigestion symptoms.