How is heartburn treated?

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Most people occasionally experience heartburn, usually after eating, but some people have more frequent or more severe heartburn. You can use a variety of home remedies, lifestyle changes, and over-the-counter products to help alleviate this symptom.

Heartburn is also called acid reflux because it occurs when stomach acid comes in contact with the lining of the esophagus , causing irritation. It can happen when the lower esophageal sphincter (LES), the muscle that opens and closes between the esophagus and the stomach, is weakened or relaxed and not doing its job properly. Some treatments aim to avoid the use of substances that weaken LPS and the physical impairment of its function. Other treatments aim to reduce stomach acid production, dampen it, or prevent irritation of the esophagus .

If you experience heartburn and need to use a heartburn remedy more than twice a week, you should see your doctor. You may have gastroesophageal reflux disease (GERD), and your doctor may recommend more effective treatments, including prescription medications.

Illustration by Jessica Olah, Get Meds Info

Home remedies and lifestyle

You can ease heartburn by avoiding the foods that cause it and choosing a lifestyle that can minimize heartburn.

No Smoking

Nicotine relaxes the esophageal sphincter. Smoking also stimulates gastric acid production. Stop smoking and avoid secondhand smoke.

Lose weight when you are overweight

Being overweight or obese puts pressure on your stomach and increases your risk of heartburn. Reducing heartburn is one of the many reasons why you should strive for a BMI of 30 or less.

Loosen the belt

Tight clothing around the waist increases pressure on the abdomen. Belts, leggings, and compression garments, such as flip flops, are common sources.

Avoid food and drink triggers

Some heartburn triggers are common, while others will be different for each person.

  • Drinking alcohol before, during, or after meals can make heartburn worse because alcohol weakens the LES muscle. Also, drinking alcohol can cause you to eat more than planned and make you choose the wrong foods.
  • Avoid foods and drinks that weaken the LES muscle. These foods include chocolate, peppermint, caffeinated drinks, soda, alcohol, fatty foods, and fatty or fried foods.
  • Avoid foods and drinks that can irritate the esophagus. These include citrus fruits and juices, tomatoes, and foods made from tomatoes, chili, and black pepper.
  • Create a heartburn-free diet by keeping a food diary to record which foods are safest for you and which are most likely to cause heartburn. You can enjoy some foods from time to time or in smaller amounts, while you will find others that you should avoid most of the time.

Feeding Habits

In addition to what you eat and drink, how and when you do it can also cause heartburn.

  • Eat less and more often. Heavy meals increase the pressure on the stomach and the LES muscle. It is better to eat five or six small meals rather than three large ones. Don't eat too fast. Putting a fork or spoon in between bites can help you with this.
  • Do not lie down for two to three hours after eating. If you like to relax on the couch, read, watch TV or videos, do so sitting down, or at least with your head and shoulders upright.
  • Don't eat two to three hours before bed. Nighttime heartburn is common and can be triggered by the presence of food in the stomach. You can also eat less food for dinner and should avoid late-night snacks.
  • Foods and beverages that have been used as natural antacids include bananas and chamomile tea. Fresh ginger and turmeric are also traditionally used to aid digestion.
  • Chewing gum or sucking on hard candy or lozenges within 30 minutes of a meal is known to stimulate saliva production, which can help relieve symptoms of heartburn. Because saliva is alkaline, it helps neutralize acid. The saliva washes the esophagus and returns the acid from the reflux to the stomach. However, this solution does not work for everyone as it can lead to swallowing excess air, which can lead to bloating and increased flatulence.
  • Drinking warm liquid or herbal tea after meals can dilute and remove stomach acid from the esophagus.

Sleeping habits

Almost 80% of people with heartburn experience heartburn at night . In addition to skipping meals too early before bed, there are ways to ease that burn so you can get a good night's sleep. Some of these methods include:

  • Sleep with your head and shoulders raised. In the supine position, the stomach contents are pressed against the LES. When the head is higher than the belly, gravity helps relieve this pressure. There are two ways to raise your head a few inches. Place bricks, blocks, or something sturdy under the legs of the bed by the headboard. You can also use an extra pillow or wedge-shaped pillow to lift your head.
  • Lie on your left side
  • Wear loose-fitting pajamas.

Sodium bicarbonate

Baking soda, also known as baking soda, is a natural antacid.

When you dissolve a teaspoon of baking soda in 8 ounces of water and drink it, it neutralizes stomach acid and temporarily relieves heartburn caused by acid reflux.

This method has its drawbacks. When you add baking soda to the water, it releases carbon dioxide, causing it to sizzle. This soda can open up the LES, allowing you to burp and help relieve pressure from swelling. Unfortunately, opening the LES can also cause stomach contents to wash into the esophagus. Although many people have used baking soda, no clinical trials have been done to support the effect of baking soda on heartburn.

Home remedies not proven or disproven

Apple cider vinegar fans speculate that heartburn is caused by a lack of stomach acid. They think that eating apple cider vinegar increases stomach acid levels, allowing the stomach to digest food properly and causing heartburn . However, this is the opposite of what medical experts believe. Health professionals recommend taking antacids and medications to reduce stomach acid and control acid reflux symptoms.

There are no published clinical trials supporting the use of apple cider vinegar for heartburn, and a master's thesis found no difference in the use of vinegar or a placebo for heartburn.

Taking undiluted apple cider vinegar can irritate your mouth and esophagus and destroy tooth enamel, as it is very acidic. Dilute it with water if you plan to use it, for example 1-3 teaspoons of vinegar per glass of water. Vinegar can interact with other medications that you are taking at the same time. Instead of relieving heartburn, vinegar can make it worse. If you plan to use apple cider vinegar to treat heartburn, it is important that you speak with your doctor first.

Heartburn Discussion Guide

Get our printable guide to your next doctor's appointment to help you ask the right questions.

Drinking cold milk can ease acid reflux burns at first. But later, the opposite effect can occur, when the same drink with milk causes gastric juice production or slows stomach emptying (which also plays a role in heartburn and GERD). This is especially true with whole milk. Skim milk is generally recommended in GERD diets, not as a cure for heartburn, but as part of a heartburn-promoting meal plan .

OTC Treatments

Today, you have several over-the-counter heartburn remedy options, some of which were only available by prescription a few years ago.

Note:

Over-the-counter medications are for short-term relief and you should see your doctor to find out about ongoing symptoms of heartburn.

Antacids

Antacids are commonly used to treat heartburn. They can relieve occasional heartburn and indigestion . Active ingredients in antacids neutralize stomach acid that causes pain.

Antacids are sold under the following brand names, and each may have a different formulation, which may have the same or different ingredients:

  • Rolydes: Rolydes are available over the counter in a variety of strengths, including super strength, extra strength, and regular, as well as in various forms, such as soft chewable tablets and liquid. All formulations contain calcium carbonate and magnesium hydroxide.
  • Mylanta : Mylanta is an antacid that contains aluminum hydroxide and magnesium hydroxide. Mylanta ultra tablets, chewable tablets and gelatin capsules contain antacid calcium carbonate.
  • Tums – The active ingredient in Tums is calcium carbonate, which is generally stronger and longer-lasting than some antacid products. Calcium carbonate can also increase mobility (movement) in the esophagus by decreasing exposure to acid.
  • Gaviscon : Gaviscon contains alginic acid and sodium bicarbonate in addition to the acid neutralizing ingredients found in most antacids (aluminum hydroxide and magnesium carbonate). The combination creates a foam barrier that traps stomach acid. This jelly-like barrier displaces the pocket of acid at the junction of the esophagus and stomach and can help reduce reflux episodes. It may also have a longer lasting effect against heartburn in people with gastroesophageal reflux disease (GERD) .
  • Chooz: is a sugarless gum with a calcium carbonate antacid. You chew a bite or two after every meal.

Note:

Pregnant women should not use antacids that contain sodium bicarbonate or magnesium trisilicate. Talk to your doctor about any antacid use during pregnancy and what to use to relieve heartburn.

Antacids are not intended for long-term use. If you take antacids for more than two weeks, your heartburn may be due to a more serious medical problem. Consult with your healthcare professional for further evaluation. You should see your doctor first if you experience any symptoms severe enough to interfere with your lifestyle.

Tell your doctor immediately if you experience:

  • Rash, itching or hives, swelling of the face, lips or tongue (which may indicate an allergic reaction)
  • Confusion
  • Headache
  • Irritability
  • Nausea or vomiting
  • Unexplained weakness or tiredness.

H2 blockers

H2 blockers (also called H2 receptor antagonists) are drugs that reduce the amount of acid in the stomach. Histamine-2 stimulates the parietal cells of the stomach lining to produce acid. H2 blockers reduce acid production by blocking histamine signals that tell the stomach to make acid.

H2 blockers are sold under the following brand names:

  • Axid (nizatidine)
  • Pepcid (famotidine)
  • Tagamet (cimetidine)
  • Zantac (ranitidine)

Update April 1, 2020: The Food and Drug Administration (FDA) announced the recall of all drugs that contain the ingredient ranitidine, known under the brand name Zantac. The FDA has also recommended not taking over-the-counter ranitidine and that patients taking prescription ranitidine discuss other treatment options with their healthcare provider before stopping their medication. For more information, visit the FDA website .

Side effects are rare with H2 blockers . H2 blockers are well tolerated by most people when taken as directed. Other medical conditions or medications can increase your risk of side effects.

Side effects that you should report to your doctor or healthcare professional:

  • Allergic reactions such as skin rash, itching or hives, swelling of the face, lips or tongue.
  • Emotion, nervousness, depression, hallucinations.
  • Inflammation of the breasts, pain
  • Redness, blistering, or peeling of the skin, including in the mouth.
  • Dark urine
  • Diarrhea
  • Headache
  • Nausea or vomiting
  • Yellowing of the skin or the whites of the eyes.

If you have been taking your maximum dose of OTC H2 blocker for two weeks and you still have heartburn, you should see your doctor.

Proton pump inhibitors (PPIs)

Proton pump inhibitors (PPIs) completely block gastric acid production. They do this by turning off a system in the stomach known as a proton pump. In this system, the non-acidic potassium ion is removed from the stomach and replaced with an acidic hydrogen ion. Stopping the pump stops the secretion of acid in the stomach.

These PPIs are available over the counter and in prescription doses:

  • Nexium 24H (esomeprazole)
  • Over-the-counter prilosec (omeprazole)
  • Prevacid 24H (lansoprazole)
  • Over-the-counter Zegeride (omeprazole / baking soda)

PPIs are generally taken every two weeks and should not be taken for a long period of time. If you need to do this more than every four months, you should see your doctor.

Possible side effects of PPI use . Contact your doctor if you experience any of these possible side effects:

  • Headache
  • Diarrhea
  • Constipation
  • Stomach ache
  • Threw up
  • Abdominal pain
  • Cough
  • Cold symptoms
  • Dizziness
  • Mild rash

Tell your doctor immediately if you experience:

  • Severe skin rash with swelling or peeling
  • Urticaria
  • Swelling of the face, mouth, lips, or tongue.
  • Swelling of the hands, feet, or ankles.
  • Severe diarrhea
  • Hoarseness

Recipes

Heartburn is a symptom of GERD. If you see your doctor about frequent heartburn, you may be prescribed medications used for GERD.

Prescription H2 blockers

In addition to the over-the-counter H2 blockers, you may be given a higher dose. Axid (Nizatidine), Pepcid (Famotidine), and Tagamet (Cimetidine) are available by prescription.

Prescription proton pump inhibitors (PPIs)

Healthcare professionals prescribe PPIs to treat people with gastroesophageal reflux disease (GERD), peptic ulcer , or other digestive disorders that can cause excess stomach acid.

Prescription proton pump inhibitors are available under the following brand names and may have common formulations:

  • Prilosec (omeprazole)
  • Prevacid (lansoprazole)
  • Protonix (pantoprazole)
  • Nexium (esomeprazole)
  • Acifex (rabeprazole)
  • Dexilant (dexlansoprazole)

Prescription PPIs should be taken under medical supervision and only for a limited period of time. Chronic PPI use has been linked to heart attacks, kidney disease, and bone fractures.

Complementary Medicine (CAM)

There are several types of CAM that have some evidence to support their use for heartburn.

Aloe vera syrup products

Aloe vera juice has been used in traditional medicine to treat irritation of the esophagus. It is not advisable to use raw aloe vera juice as it contains laxative compounds, but some products are designed for internal use. AloeCure contains organic aloe juice and is marketed as an all-natural remedy for digestive disorders, including heartburn. Several trials, including a 2015 study, have shown aloe vera syrup to be effective for heartburn symptoms. Keep in mind that eating aloe can lower blood sugar levels. Discuss using aloe with your doctor if you have diabetes, hypoglycemia, thyroid disease, kidney disease, heart disease, or electrolyte disturbances.

Licorice deglycyrrhizinate

Licorice deglycyrrhizinate (DGL) is a natural remedy that is sometimes recommended to relieve symptoms of heartburn and other digestive disorders.

Licorice can raise blood pressure and have unwanted effects; As a result, deglycyrrhizin licorice is sometimes used as this form of licorice does not appear to have the same side effects.

However, you should not use DGL if you have been diagnosed with hypertension and / or are undergoing treatment for hypertension. You will find DGL or licorice in chewable tablets, powder, or tea. Scientific studies are few and far between and do not provide sufficient evidence that licorice is effective for heartburn. However, there are several small studies like the 2012 study that show some positive results.

Please note that the purity, safety, or efficacy of dietary supplements and herbal products are not regulated or controlled.

Side effects of antacid use are more likely with prolonged use or in higher doses than recommended. Side effects, such as constipation or gas in the stomach, generally do not require medical attention unless they continue or become bothersome.

Frequently asked questions

  • Symptoms of heartburn can include:

    • A burning sensation in the upper chest or throat
    • Swallowing problems
    • Sour or bitter taste in the mouth
    • Chronic cough
    • Wheezing or other asthma symptoms

  • Heartburn can last from a few minutes to several hours. For some, this rarely happens, while for others it can happen more often. Make sure to make an appointment with your doctor if you experience heartburn more than twice a week.

  • Over-the-counter antacids like Tums , Mylanta , or Rolaids, which neutralize stomach acid, are good options for quick, short-term relief from mild heartburn. However, antacids, along with other over-the-counter medications such as H2 blockers and proton pump inhibitors (PPIs), are not intended to provide long-term support.

  • Home remedies for heartburn may include:

    • Drink 1 teaspoon of baking soda mixed with 8 ounces of water.
    • Including foods and teas rich in fresh ginger or turmeric.
    • Drink hot herbal teas after meals, such as chamomile or slippery elm.
    • Keep your upper body upright for two to three hours after eating.
    • Wear loose clothing
    • Deep belly breathing
    • Sugar-free gum

  • Over-the-counter antacids that contain calcium carbonate are the best option. Certain other antacid ingredients are not recommended during pregnancy because they may not be safe for your baby, such as aspirin or magnesium trisilicate. Baking soda (baking soda) can cause fluid retention during pregnancy.

  • If over-the-counter medications don't work, talk to your doctor about using prescription acid suppressants for a short period of time. Prescription H2 blockers can reduce the amount of stomach acid, while PPIs can completely block it. However, PPIs are not without side effects and it is important to take them only for short courses.

  • The following lifestyle changes can help prevent heartburn:

    • Give up smoking
    • Wearing clothes with a looser belt
    • How to control your weight
    • Eat less and more often
    • Sleep with your head and shoulders up.
    • Avoid food and drink triggers such as alcohol, caffeine, chocolate, peppermint, fried or fatty foods, citrus fruits, tomatoes, and hot peppers.

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