5 Things Doctors Do When They Have Heartburn

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Apples are high in pectin, which may help combat heartburn.
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Large meals. Acidic foods. Alcoholic drinks. What do these things have in common? They're often found at holidays and celebrations — and they're also common heartburn triggers.

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Of course, triggers are individual, gastroenterologist David Poppers, MD, PhD, clinical professor in the department of medicine at NYU Grossman School of Medicine, tells LIVESTRONG.com. Yours might be something totally different, like onions, garlic, caffeine, chocolate or eating close to bedtime.

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Whatever the culprit, stomach acid bubbling back up into your esophagus leads to that burning sensation in your chest, and it's mighty unpleasant.

The best remedy for heartburn is to practice moderation when eating, especially when it comes to your trigger foods. Maintaining a healthy weight, and particularly avoiding excess visceral fat ("hard" fat around the belly), is also important, Dr. Poppers says.

Of course, we're not all perfect — even gastroenterologists aren't immune to heartburn. So, we asked them how they handle it, as well as the best advice they give patients. Here's how to feel better fast (and prevent heartburn in the future):

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1. Go Low and Short

Feeling the burn? There are various medications out there you can try for relief. Dr. Poppers suggests using "the lowest dose of the safest medication for the shortest amount of time necessary," he says.

Heartburn isn't a frequent symptom he experiences personally. But for those one-off episodes, he might reach for an over-the-counter antacid, such as Maalox, Mylanta, TUMS or Rolaids. "These neutralize the acid that your body normally produces," he says.

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If that doesn't do the job, grab Pepcid, which blocks one of the receptors in the stomach that contributes to acid formation, he explains. It works quickly but also lasts longer than a regular antacid.

2. Block the Burn With Fruit Pectin

As soon as you start eating, your stomach preps for the food by making acid, gastroenterologist Amir Masoud, MD, spokesperson for the American Gastroenterological Association, tells LIVESTRONG.com.

When solid food meats liquid acid, the liquid rises to the top — and that puts it right under your lower esophageal sphincter, aka the flap that can open and let acid escape your stomach into your esophagus.

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"If I know I'm going to have a big dinner, I try to incorporate things that can push acid further down," Dr. Masoud says. "The best thing that's been studied is available OTC and I incorporate it into my own diet. It's called alginate," he says.

The OTC medication Gaviscon is an antacid and alginate, and it works by forming a protective barrier over acid.

As a non-medication option, Dr. Masoud takes fruit pectin. Yep, the same stuff you use for homemade jam that's available in packets at the grocery store. "I put pectin in a glass of water and drink it if I have heartburn," he says.

Alternatively, Dr. Masoud may eat an apple or pear — two fruits high in pectin — with his meal. "It prevents me from overeating, sops up this acid and forms a gel layer above it," he explains.

As a third option, if you regularly pop a daily gummy multivitamin (which contain pectin), you can opt to take it with your meal.

3. Stay Upright

One of the best things you can do to combat heartburn is avoid lying down for about two to three hours after eating, Bruce D. Greenwald, MD, professor of medicine in the division of gastroenterology and hepatology at the University of Maryland School of Medicine, tells LIVESTRONG.com.

"When lying down, you don't have gravity helping you out [to keep acid down in your stomach], and you're more likely to have reflux," he says.

So, let's say you went to a celebratory dinner where you ate more than usual and had a couple alcoholic beverages. Don't come home and flop onto the couch or into bed right away; rather, give yourself time to digest.

If time isn't on your side, you could try elevating the head of your bed with a wedge to stay propped up as you sleep.

4. Unpile Your Plate

"I was raised in the clean plate club," Dr. Greenwald says. "If it's on my plate, I end up eating it."

If you're a member of this club too, the most self-aware move is to recognize the habit and then either choose a smaller plate to pile your food onto or take smaller portions of food so that when you do clear your plate, you're still naturally eating less, he says.

5. Prep With a PPI

If you know there's going to be a week or so (say, a vacation or extended holiday celebrations) where you're really going to be leaning into the clean-plate-club lifestyle and getting heartburn, then it's reasonable to take a PPI for that week, Dr. Greenwald says.

PPIs are proton-pump inhibitors, and they affect the acid pump of the stomach. You need to take them about 30 minutes before eating for best results, before food turns on the acid pumps to help you digest your food.

Over-the-counter PPIs include meds with omeprazole (Prisolec), esomeprazole (Nexium) and lansoprazole (Prevacid).

"Going on a PPI for a short period of time can lead to longer-lasting relief," Dr. Greenwald says.

When to See a Doctor for Heartburn

Occasional heartburn means that it happens less than once a week, and it often occurs when overeating or drinking alcohol, Dr. Greenwald says.

However, if your heartburn is frequent, meaning three or more times per week, you're having it at night with regurgitation or have trouble swallowing, then those are red flags. "Don't just take a couple antacids and ignore it," he says.

Make an appointment with your health care provider, who may recommend tests or screenings to rule out more serious causes of these symptoms, such as precancerous changes.

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Is This an Emergency?

If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911. If you think you may have COVID-19, use the CDC’s Coronavirus Self-Checker.
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