Do GI Cocktails Really Work?

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A gastrointestinal (GI) cocktail, also known as a gastric cocktail, is a combination of different medicines you can drink aimed at relieving digestive upset and chest pain. What exactly is in a gastric cocktail can vary, and its effectiveness is highly debated.

This article looks at what ingredients are commonly used in GI cocktails, plus the possible benefits and potential side effects.

Antacid medicine being poured into a dosing cup.

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GI Cocktail Ingredients

GI cocktails are not a single product. Rather, as the name cocktail implies, it is a combination of several medications.

The exact medicines and amounts used can vary. However, three commonly used medications include:

  • Liquid antacid: A medication that helps to neutralize the acid in your stomach with the aim to relieve heartburn and upset stomach.
  • Liquid anesthetic: A medication used to temporarily numb and relieve pain in the mouth, throat, esophagus (food tube), and stomach. 
  • Anticholinergic: A​ medication that prevents the action of acetylcholine. Acetylcholine is a neurotransmitter, or a chemical messenger, that moves signals between certain cells, affecting how your body works. It is used to treat an upset stomach.

The chart below explains what ingredients are commonly used in a GI cocktail, what they are used for, and the usual dosage of each.

Ingredient Liquid Antacid Liquid Anesthetic Anticholinergic
Use/Purpose Neutralize stomach acid Temporarily numb for pain relief Relieve nausea and stomach and intestinal cramps
Brand Name Mylanta or Maalox  Xylocaine viscous  Donnatal 
Active Ingredient Aluminum hydroxide, magnesium hydroxide, simethicone  Lidocaine viscous  Atropine sulfate, hyoscyamine sulfate, phenobarbital, scopolamine hydrobromide 
Usual Dosage 0-30 mL  5-10 mL 10 mL 

How It Works

A doctor is most likely to prescribe a GI cocktail for dyspepsia (indigestion). GI cocktails are most commonly prescribed in the emergency room setting when a patient presents with a GI condition, such as acid reflux, inflammation of the intestines, or an ulcer.

In some cases, it has been used to decide whether chest pain has been caused by indigestion or a more serious heart problem. However, compared with standard diagnostic protocols for heart problems, using a GI cocktail has not been proven to improve the accuracy of diagnosis.

Individually, the ingredients used in GI cocktails are all often used to treat various GI symptoms.

Antacids are most routinely used to relieve indigestion and heartburn. Anesthetics are commonly used for short-term pain relief from minor mouth problems, such as canker sores, sore gums/throat, toothache, and mouth or gum injury.

Anticholinergics are prescribed for a variety of reasons, such as diarrhea, urinary incontinence, overactive bladder, chronic obstructive pulmonary disorder (COPD), and certain types of poisoning.

It’s thought that since these medications all work differently, the combination of all three will be more effective than just one. Many different combinations of GI cocktails are used, however there is controversy as to what is the best approach.

Indigestion Symptoms 

Symptoms of indigestion can vary from person to person, and even from day to day. It is common for indigestion to occur after eating. Some people suffer from it on a daily basis, while others only experience it occasionally.

Common symptoms of indigestion include:

  • Nausea
  • Vomiting
  • Bloating or feeling full
  • Stomach and/or abdominal pain
  • Chest pain
  • Acid reflux or heartburn
  • Constipation
  • Diarrhea
  • Gas
  • Belching

When to Go to the Hospital

Do not use a GI cocktail to try to determine whether your symptoms are that of a heart attack or indigestion. If you have any significant chest pain or other symptoms of a heart attack, go to the nearest emergency room.

Possible GI Cocktail Benefits

GI cocktails can provide pain relief from indigestion. However, there is little current research supporting its use. The majority of research supporting the use of a GI cocktail is outdated.

A small study completed in 1995 looked at practice patterns regarding administration of the GI cocktail. The study noted that a GI cocktail often provided symptom relief. 

However, because other medications, such as morphine, were often given at the same time, it was impossible to determine whether the effects were from the GI cocktail or the other medications.

Possible Disadvantages 

While GI cocktails can help relieve indigestion, they also are not without risk of side effects. Each ingredient used can produce possible undesirable side effects. 

Common side effects of antacids include:

  • Constipation
  • Diarrhea
  • Nausea
  • Vomiting
  • Headache

Common side effects of liquid anesthetics include:

  • Nausea
  • Dizziness
  • Local site reactions, such as irritation or swelling of the mouth, tongue, or throat

Common side effects of anticholinergics include:

  • Dizziness
  • Drowsiness
  • Blurry vision
  • Decreased sweating
  • Constipation

Some research suggests that GI cocktails may not be as effective as using an antacid alone. 

A small 2020 double-blind, randomized controlled trial out of Australia compared the use of antacid alone, antacid plus lidocaine solution, and antacid plus viscous lidocaine in 89 emergency room patients with indigestion.

The patients rated their pain before receiving the medication, at 30 minutes, and again at 60 minutes. 

Although pain scores decreased in all three groups, there were no significant differences in scores at either 30 or 60 minutes. Additionally, the antacid-only group scored significantly higher in palatability than the other two groups. 

The researchers concluded that there is no benefit to adding lidocaine to antacids for emergency department patients with indigestion.

An older 2003 double-blind clinical trial compared three combinations of GI cocktails commonly given for indigestion in the emergency room: antacid (group 1), antacid plus anesthetic (group 2), and antacid plus anesthetic plus viscous lidocaine (group 3).

One hundred thirteen people completed the study, rating their discomfort just before taking the medication and again 30 minutes later. The researchers concluded that pain relief between the three groups was not significantly different, suggesting that all three medications combined might not be necessary.

A 2016 journal article notes it would be more cost effective to use only an antacid for indigestion complaints and would reduce the number of possible side effects as well.

Additionally, a 2006 report for physicians determined that using an antacid alone is the preferred treatment for indigestion in the emergency room setting.

Indigestion Relief

Besides antacids, other medications are available to treat indigestion at home, many of which are available over-the-counter. These include:

  • H2 receptor blockers: Brand name: Pepcid AC. Generic name: famotidine. This type of medication works by reducing the amount of acid produced by the stomach. It is commonly used to treat GI conditions, such as acid reflux and ulcers.
  • Proton pump inhibitors (PPIs): Brand names: Prilosec, Prevacid. Generic names: omeprazole, lansoprazole. PPIs decrease the production of acid by the stomach. They are more powerful than H2 receptor blockers.
  • Prokinetics: Brand names: Reglan, Motilium. Generic names: metoclopramide, domperidone. This type of medication helps strengthen a muscle in the lower esophagus, thus helping to relieve acid reflux. These medications are only available through a prescription from your doctor.

Some natural remedies to relieve indigestion include: 

Other remedies available include lifestyle changes, such as:

  • Avoid trigger foods
  • Eat smaller meals
  • Don’t eat within three to four hours of bedtime
  • Aim for and maintain a healthy weight
  • Change your sleep position or elevate the head of your bed
  • Avoid tight-waisted clothes
  • Decrease stress
  • Quit smoking, if you smoke

Summary

A GI cocktail is a combination of three different medications used to treat indigestion. While it has been commonly prescribed in the emergency room setting, current research suggests that an antacid alone might be just as effective as a GI cocktail at relieving symptoms of indigestion.

A Word From Verywell

Occasional indigestion and heartburn are common. But if you experience these symptoms frequently, you may have an underlying condition that should be addressed. Having heartburn twice a week or more signals it’s time to talk to your healthcare professional. They can determine the best treatment plan for you.

Frequently Asked Questions

  • What can I do for indigestion relief?

    There are many different approaches for indigestion relief. These include medications, natural herbs and supplements, and lifestyle changes. Talk with your doctor about what might be the best option for you.

  • Does a GI cocktail work?

    GI cocktails can help relieve indigestion. However, studies have shown that antacids alone might be just as effective.

  • What is a pink lady?

    A pink lady is another term used for a GI cocktail, which is a combination of medications used to treat indigestion in the emergency room setting. It gets its name from the color it takes on from using pink-hued medication as part of its preparation.

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