Heartburn happens to almost all of us now and again. And while there’s nothing fun about that burning sensation in your chest or that sour taste in your throat, it’s typically not a reason to worry if it happens sporadically.
Fortunately, most of us can pop an antacid to get some relief and make a promise to dial back on the onions next time. But what if that burning still persists? Or it happens on a regular basis? That could mean it’s time for a different approach — or a stronger medication. (Need to put out the fire for less? We can help. Bring our free prescription discount card to the pharmacy to see how much you could save.)
Treating heartburn isn’t a one-size-fits-all process. Here’s how to know which heartburn medication is right for you.
What is heartburn?
Heartburn is a symptom of acid reflux. Reflux happens when the valve that separates your esophagus from your stomach is open at times that it shouldn’t be. That allows whatever is in your stomach — acid, digestive juices, food — to flow back up into your esophagus and cause irritation.
Symptoms can vary. For many people, heartburn can feel like burning in the chest or throat. Others may have difficulty swallowing or experience a sour, acidic taste in their throat.
Heartburn can be more than a nuisance, though. If it happens on a regular basis or keeps you up at night, it could be a sign of gastroesophageal reflux disease (GERD), says Ceciel Rooker. She’s the president and executive director of the International Foundation of Gastrointestinal Disorders in Mount Pleasant, South Carolina.
GERD is a chronic condition that happens when acid reflux becomes more frequent. And it can have some serious side effects. Over time, that irritation to your esophagus can lead to damage and ulcers, and even put you at risk for esophageal cancer, according to the Mayo Clinic.
What causes heartburn?
There’s no single thing that causes it. Some health conditions or medications can prompt acid reflux — and the resulting heartburn. There’s GERD, for one. Certain medications such as anti-inflammatories can also irritate the esophagus, making reflux more likely.
And then there’s pregnancy. In fact, more than half of pregnant women report experiencing severe heartburn, according to the Cleveland Clinic. This might be because some hormones slow down the digestive system during pregnancy. Plus, as the baby grows, your expanding uterus can put pressure on your stomach.
There are also a lot of possible heartburn triggers in daily life. Being really stressed, eating too close to bedtime, smoking and eating large portions at a single meal are a few common ones, says Rooker. Wearing tight clothes or belts can also put upward pressure on your stomach, triggering reflux.
Of course, certain foods have been linked to heartburn, too. High-fat foods (think: fried foods, cheesy dishes and fatty meats such as sausage) can stay in your stomach for longer. This can increase stomach pressure, trigger your stomach to make more acid, and make reflux more likely. Some of the other most notorious culprits include:
- Tomato-based foods
- Citrus foods and drinks
- Carbonated drinks
- Caffeinated drinks
How do you prevent heartburn?
Avoiding or addressing your triggers can help keep heartburn at bay. When in doubt, talk to your doctor about your symptoms, especially if you’re experiencing heartburn 2 or more times per week, advises Rooker.
The Mayo Clinic advises some other simple steps you can take to reduce stomach pressure. These include:
- Eating at least 3 hours before bed (or before lying down)
- Elevating the head of your bed if you experience discomfort at night (or inserting a wedge under your mattress)
- Avoiding large meals
For many, a combination of lifestyle changes and over-the-counter (OTC) medications can treat heartburn right at home. For those with more severe symptoms or GERD, prescription medications and other treatments may be used.
What medications can you take for heartburn?
There are several options for treating everything from occasional discomfort to more severe GERD-related heartburn. The 3 main types of heartburn medications are antacids, histamine-2 (H2 blockers) and proton-pump inhibitors (PPIs). Each one works differently and works best under certain conditions.
Antacids can help make stomach acid less acidic. They’re available over the counter. And they’re a good choice if you get heartburn every now and again and just want it to go away quickly. You can take an antacid about an hour after you eat or whenever heartburn hits. Antacids work within minutes, but they last for only about an hour.
They come in tablet forms such as Tums® or liquid forms such as Gaviscon®. The liquid kinds work faster, but they aren’t always as convenient.
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Caution: Some antacids contain magnesium or sodium bicarbonate, which can have a laxative effect. Also, be sure not to take more than the recommended dose, especially of antacids that contain calcium. Too much calcium can cause kidney stones, warns the Mayo Clinic.
These medications block the chemical histamine in your body, which reduces the amount of acid that the stomach makes. They’re largely available as OTC products, such as Pepcid AC® and Tagamet HB®. But there are stronger versions available by prescription. For example, Pepcid® (famotidine) is also available in a stronger version by prescription only.
H2 blockers usually take about 30 to 90 minutes to begin working. But the effects can last much longer than antacids. That’s why they’re a good choice for people with more regular heartburn whose symptoms are longer lasting, Rooker says. Many people take an H2 blocker before the first or last meal of the day, according to the U.S. National Library of Medicine.
Still, OTC H2 blockers are not necessarily meant for long-term management of frequent heartburn. Talk to your doctor if you find yourself taking them most days for 2 or more weeks.
Caution: Tell your doctor and pharmacist what other medications you’re taking. H2 blockers can interfere with how some medicines work. Side effects can include headaches, dizziness and diarrhea. Taking an H2 blocker might also cause more serious side effects such as confusion, chest tightness, fever, bleeding or an irregular heartbeat.
Proton-pump inhibitors (PPIs)
These are stronger acid blockers than antacids and H2 blockers. PPIs can reduce the production of stomach acid even more than H2 blockers, making them a good choice for people with frequent heartburn, GERD and stomach ulcers, according to the U.S. Food and Drug Administration (FDA).
“PPIs are typically prescribed when people don’t get relief from antacids or H2 blockers,” Rooker says. “They can take a while to work, but they are very strong.”
Most PPIs are now available without a prescription. Common PPIs include Nexium®, Prevacid® and Prilosec®. But the OTC versions are meant to be taken for only 14 days at a time, up to 3 times a year, says the FDA, unless you’re directed otherwise by your doctor.
Caution: Side effects from taking a PPI are rare, but they can include headache, diarrhea, nausea and itching. PPIs can also impact the way some medications work, including anti-seizure medications and blood thinners.
No matter how often or how severe your heartburn is, rest assured, there’s a treatment out there that will work for you.
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Heartburn overview: Cleveland Clinic
GERD symptoms and causes: Mayo Clinic
H2 blocker basics: MedlinePlus
Overview of OTC medications for heartburn: U.S. Food and Drug Administration