Occasional heartburn might result after a large holiday meal, or a night out drinking alcohol and eating greasy food, or perhaps from not having eaten recently enough. However, when heartburn becomes frequent and chronic, it is likely a symptom of gastroesophageal reflux disease (GERD). OTC Proton pump inhibitors (PPIs) are used to treat frequent heartburn and work by reducing the amount of acid in the stomach4. In contrast, prescription PPIs are used to treat conditions like gastoesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. Antacids.
Before taking any antacids or PPIs, you should talk to your healthcare provider. There may be limitations on what you can take and how often you should take it, especially if you are on dialysis.
Heartburn that occurs more than twice a week may be considered symptomatic of gastroesophageal reflux disease (GERD). GERD occurs when the lower esophageal sphincter does not close properly and allows the stomach contents to splash back (reflux) into the esophagus. Stomach acid irritates the lining of the esophagus and causes heartburn. For people with more frequent symptoms of GERD, histamine H2 receptor antagonists, also called H2 blockers, block the action of histamine, which is a chemical in the body that triggers the formation of stomach acid. H2 receptors thereby reduce the amount of acid produced.
Calcium channel blockers are commonly used for high blood pressure and angina. Theophyllines are oral medications, commonly used for asthma and breathing difficulty. These types of medications weaken the lower esophageal sphincter, making it easier for stomach acid to reflux into the esophagus. When doctors prescribe PPIs, benefits like reducing hospitalizations for GERD generally outweigh the risk of rare side effects associated with the drugs, says Joel Rubenstein, MD, an associate professor of gastroenterology at the University of Michigan Medical School in Ann Arbor. But the picture is different for many people who buy PPIs without ever seeing a doctor, he adds.
Ask Well: Taking Heartburn Drugs Long-Term
A potent option for heartburn that doesnâ€™t respond to other over-the-counter medications, though it requires a two-week course of treatment. Relaxation therapies. Techniques to calm stress and anxiety may reduce signs and symptoms of GERD. Ask your doctor about relaxation techniques, such as progressive muscle relaxation or guided imagery.
- This may lead to ulcers and narrowing of the esophagus.
- â€œThe stomach produces acid normally – itâ€™s supposed to, to help digest food for absorption,â€ says Matthew J. Wyneski, MD, associated staff member in pediatric gastroenterology at the Cleveland Clinic in Ohio.
Taking antacids like Tums, Rolaids, Pepto-Bismol or Milk of Magnesia episodically to relieve heartburn is unlikely to have these effects, and while H2 blockers are known to have side effects like headaches, constipation and nausea, their long-term use has not been studied as extensively as that of proton pump inhibitors. Several studies have also reported that proton pump inhibitors increase the risk for pneumonia in hospital patients; a similar increase was not seen among patients taking a different type of acid-reflux drug called a histamine-2 receptor blocker (a drug like Pepcid or Zantac), Dr. Herzig said. Over the past five years, the federal Food and Drug Administration has issued numerous warnings about proton pump inhibitors, saying that long-term use, defined as a year or more, increases the risk of hip, wrist and spine fractures (though studies have found an increase in bone fractures with use over shorter periods).
That’s because hormones cause the digestive system to slow down. The muscles that push food down the esophagus also move more slowly when you are pregnant. And as the uterus grows, it pushes on the stomach.
Best heartburn relief treatment for you
You may wonder if an OTC or prescription GERD medication would be better for you. The right choice depends on how frequent and severe your symptoms are.
Gastroesophageal reflux disease (GERD)
Proton pump inhibitors include AciphexÂ®, NexiumÂ®, PrevacidÂ®, PrilosecÂ®, and ProtonixÂ®. For people with mild-to-moderate disease, home care and H2-blockers are generally effective. Let your doctor what you are doing about your reflux disease and how well it is working.