Heartburn Health (cont.)

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Heartburn Medical Treatment

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The doctor will recommend treating heartburn in a gradual progression.

Over-the-counter antacids are the oldest effective self-treatments for heartburn. Through the centuries, people have chewed on chalk (the active ingredient is calcium carbonate) to ease heartburn. Tablets are less powerful in neutralizing stomach acid than liquid antacids.

  • Antacids are useful because they provide rapid, but temporary relief of heartburn, especially if it is caused by foods or certain activity. Over-the-counter (OTC) antacids do not prevent heartburn from returning or allow a patient's injured esophagus to heal. If the patient need antacids for more than two weeks, talk to a your doctor to have the condition reviewed and receive appropriate treatment.
  • Most varieties of antacids you can buy in drug stores are combinations of aluminum and magnesium hydroxide. Antacids containing these ingredients may produce unwanted diarrhea or constipation. Discuss these medications with your doctor before use if you have any history of kidney (renal) disease.
  • Antacids containing calcium carbonate are the most potent in neutralizing stomach acid. Popular brands are Tums and Titralac.

Follow label instructions and do not take more than the recommended daily dose. Most commonly, patients take antacids after meals and at bedtime, or when they have symptoms.

Always tell a doctor about your antacid use.

Heartburn Medications

If the patient still has heartburn symptoms after lifestyle modifications and use of antacids, the doctor may prescribe drugs.

  • Histamine-2 blockers decrease the amount of acid the stomach produces. Examples include ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid, Axid AR). Many of these drugs can be purchased over-the-counter at lower doses, but patients will need a doctor's prescription for higher doses. They provide relief of symptoms within 30 minutes and are taken twice a day.
  • If heartburn persists, the doctor may recommend adding a drug such as metoclopramide (Reglan). This drug empties food and acid quickly from the stomach so less acid can reflux back into the esophagus. Reglan also helps tighten the LES muscle.
  • If the patient still has symptoms, the doctor will then recommend drugs called proton pump inhibitors. Examples of these drugs include omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium), and pantoprazole (Protonix). These compounds prevent the stomach from secreting acid. They are very effective and are typically taken once a day. These drugs are usually only prescribed if other drugs have not helped the symptoms. Many of these drugs can be bought OTC at lower doses, however, a doctor's prescription is required for higher doses.
Medically Reviewed by a Doctor on 4/21/2014

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