Acid reflux describes movement of acidic stomach contents into the esophagus. Occasional reflux is common and typically doesn’t cause problems. Researchers reported in May 2005 in "Gut" that approximately 6 percent of Americans report acid reflux at least once weekly. Acid reflux that becomes disruptive or causes complications is known as gastroesophageal reflux disease, or GERD. Reflux symptoms typically occur after meals and commonly include a burning sensation in the chest and/or throat, an acid taste in the mouth or even chest pain. Quick-acting medications typically provide prompt relief. Slower-acting medicines and prevention strategies can also be helpful for frequent acid reflux.
Quick-Acting Medicines and Actions
For occasional reflux, an antacid is often a good choice for providing quick symptom relief. Antacids work by neutralizing stomach acid and usually provide relief within 30 minutes. Examples include:
-- Calcium carbonate (Tums, Rolaids).
-- Aluminum and magnesium hydroxide with simethicone for gas (Mylanta, Maalox).
-- Aluminum hydroxide and magnesium carbonate (Gaviscon).
-- Bismuth subsalicylate (Kaopectate, Pepto Bismol).
Antacids and other quick-acting medicine may not be available or advisable for some people. Nonmedicinal options can also sometimes provide fairly rapid relief from acid reflux symptoms, including:
-- Removal of tight clothing to decrease pressure on the stomach.
-- Walking to promote stomach emptying and reduce stomach pressure.
-- Chewing gum or sucking on hard candy to wash acid back into the stomach.
When walking around your local pharmacy, you will see other medicines to treat acid reflux. Proton pump inhibitors, or PPIs, and histamine H2-receptor antagonists, or H2-blockers, are acid reducers -- though they don't provide immediate symptom relief. H2-blockers reduce acid production stimulated by histamine and take effect in about an hour. H2 blockers include ranitidine (Zantac), cimetidine (Tagamet) and famotidine (Pepcid).
PPIs shut down stomach acid pumps and are more potent acid reducers than H2-blockers. However, it can take several days for PPIs to be fully effective. Examples include:
-- Omeprazole (Prilosec, Zegerid).
-- Esomeprazole (Nexium).
-- Pantoprazole (Protonix).
-- Lansoprazole (Prevacid).
-- Rabeprazole (Aciphex).
An Ounce of Prevention
Preventive measures can be helpful, especially if you have GERD. The American College of Gastroenterology and the American Gastroenterological Association recommend:
-- Weight loss for those who are overweight or obese.
-- Elevating the head of the bed several inches, if nighttime reflux is a problem.
-- Not lying down until several hours after a meal.
-- Acid-reducing medication for GERD.
Neither of these professional groups recommends eliminating all foods that can potentially trigger reflux, such as caffeine, chocolate, alcohol and fatty foods as across-the-board avoidance has not been proved effective. However, if certain foods trigger your symptoms, limiting or avoiding them can be helpful.
Warnings and Precautions
Occasional reflux is typically not worrisome, but there are situations that require medical attention. If you have frequent or troublesome reflux, see your doctor for evaluation, especially if you experience:
-- Difficult or painful swallowing.
-- Unintended weight loss.
-- Tarry, black or bloody stools.
-- Vomiting of blood or material resembling coffee grounds.
-- Chronic cough or a voice change.
Chest pain can occur with reflux -- but may also signal a heart attack. Seek emergency medical care if you have heartburn or chest pain that is not relieved by antacids, especially if accompanied by:
-- Shortness of breath.
-- Jaw, neck or arm pain.
-- Cold sweating.
-- Dizziness or fainting.
Medical advisor: Jonathan E. Aviv, M.D., FACS