How to ease the pain of acid reflux
Treating heartburn isn’t just about putting out the fire. You can prevent a whole range of symptoms and complications, too.
We all contend with a little heartburn from time to time. But if you’ve been popping antacids like candy, chances are it’s time to check in with your provider. You could be having a bout of gastroesophageal reflux disease, also known as GERD. And you may need a medication that’s more effective than a simple antacid. Here’s what you need to know.
What is GERD, anyway?
“GERD happens when acid from your stomach bounces up into your esophagus,” says Dennis Williams, PharmD, an associate professor in the pharmacotherapy and experimental therapeutics division at UNC Eshelman School of Pharmacy. “It causes symptoms such as heartburn, belching or burping, and an acid taste in the mouth.”
Some people might have a cough, sore throat, hoarseness, abdominal pain or tooth decay, he says. Then there are the more serious symptoms, such as difficulty swallowing, coughing up blood or weight loss. If you have any of those, you should seek medical attention, Williams says.
GERD is very common. It affects 1 in 5 people in the U.S., according to the International Foundation for Gastrointestinal Disorders.
Why aren’t antacids always enough?
“Antacids can be helpful, and they start to work fast,” says Jill Morgan, PharmD, chair of pharmacy practice and science at the University of Maryland School of Pharmacy. The downside? “They only last about an hour,” she says.
These remedies usually contain calcium, aluminum and magnesium, which can help neutralize the acid that’s causing your symptoms. They’re great for those once-in-a-while bouts of heartburn. But they’re advised only for people whose symptoms are infrequent, says Morgan. That means less than twice a week.
What’s a better option for treating GERD?
Meet famotidine (Pepcid®), a different kind of heartburn treatment. Famotidine is known as a histamine-2 antagonist (or H2 blocker), Williams says. Here’s a little of the science behind it:
“There’s a histamine pump in your stomach. When it turns on, it produces more stomach acid, says Williams. “H2 blockers slow the pump down. As a result, there is less acid production in the stomach.”
These H2 blockers are more effective than regular antacids. The main reason? They decrease acid production. Plus, “They have the advantage of working quickly, in about 30 minutes. So that means they can be used when GERD symptoms are present,” Williams says. They also last much longer than an antacid — about 10 hours, to be exact, Morgan says.
Other types of H2 blockers include cimetidine (Tagamet®) and nizatidine (Axid®).
Your doctor may also recommend a proton-pump inhibitor (PPI). They work by blocking certain cells that produce acid in the stomach, according to International Foundation for Gastrointestinal Disorders. Another benefit of PPIs? They can help heal any damage in your esophagus caused by the acid reflux.
Common ones include omeprazole (Prilosec®) and lansoprazole (Prevacid®). Remember: Always check in with your healthcare provider before starting a new medication. (And don't forget: If you need help paying for your prescription medications, Optum Perks can help. Learn more now.)
What else can you do to manage GERD?
Before considering new medications, or as an additional strategy, Williams suggests making lifestyle changes that can help reduce heartburn symptoms. “This could be losing weight, avoiding coffee and alcohol, not lying down with a full stomach, and/or elevating the head of the bed,” he says. “If those things don’t work, we think about medications.”
Are there any other symptoms to watch for?
If any of the following occur, it’s time to check back in with your provider for additional follow-up:
• Using daily treatment for longer than 2 weeks
• Trouble swallowing
• Unexplained weight loss, a chronic cough or wheezing
• Vomiting blood or material that looks like black coffee grounds
• Chest pain after an activity climbing stairsThese can all be signs of more serious illnesses, so don’t delay. Make that call.
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