Whether you suffer from reflux only after eating too much or experience it more frequently, you know how unpleasant it can be. Your esophagus carries food from your mouth to your stomach. When the muscular ring between your esophagus and stomach becomes weak or too relaxed, stomach contents come back up and may cause heartburn. Occasional reflux is often relieved with dietary and lifestyle changes. But over-the-counter and prescription medicines can also be used to control your symptoms. Talk with your doctor about what medication is best for you.
Over-the-counter antacids provide quick heartburn relief by neutralizing stomach acid. The various antacids on the market contain one or more active ingredients, such as aluminum or magnesium hydroxide, calcium carbonate and sodium bicarbonate. Some antacid products also contain simethicone, which breaks down gas bubbles in your stomach to relieve bloating and belching. Others contain alginic acid, which foams in the stomach and may protect your esophagus from exposure to refluxed stomach contents. Although quick-acting, antacids are effective for just a few hours. Possible side effects if you use antacids frequently include constipation and diarrhea. Talk with your doctor before taking an antacid if you have kidney or heart disease, or high blood pressure.
Medicines that coat your esophagus and stomach may provide short-term relief of heartburn caused by reflux. Over-the-counter products typically contain the active ingredient bismuth subsalicylate (Kaopectate, Pepto-Bismol). Talk with your doctor before taking these products if you take a blood thinner, have a bleeding disorder or are allergic to aspirin. Your doctor may recommend the prescription medicine sucralfate (Carafate) if you have inflammation in your esophagus from gastroesophageal reflux disease, or GERD.
H2 blockers are medicines that limit the amount of acid your stomach produces. These medicines are available over the counter and include cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac). H2 blockers take effect in 30 to 90 minutes, but some also contain an antacid to provide faster relief for occasional heartburn. These medicines effectively limit stomach acid production for about 12 hours. Possible side-effects include headache, diarrhea, dizziness, tiredness and rash. Talk with your doctor before taking an H2 blocker if you are already taking oral medication for asthma or to control seizures, or if you have kidney disease.
Proton Pump Inhibitors
If you suffer from frequent, recurring reflux, ask your doctor about using a medication called a proton pump inhibitor, or PPI. These medicines stop acid production in your stomach but do not take effect for 1 to 3 days. Some are available over the counter, including esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec). Other PPIs are available only with a prescription, such as pantoprazole (Protonix), rabeprazole (AcipHex) and dexlansoprazole (Kapidex). PPIs are the recommended initial treatment for GERD. Possible short-term side effects include headache, diarrhea, constipation, nausea and itching. Do not use an over-the-counter PPI for more than 2 weeks unless your doctor has advised you to do so.
Other Warnings and Precautions
Although occasional reflux is usually not harmful, talk with your doctor if you experience heartburn symptoms more than twice a week or have periodic heartburn for more than 3 months. Seek immediate medical attention if you vomit blood or material that looks like coffee grounds, or have difficulty breathing, cold sweats or chest, arm, shoulder or jaw pain.
- Family Practice Notebook: Gastroesophageal Reflux
- American College of Gastroenterology: Diagnosis and Management of Gastroesophageal Reflux Disease
- Gastroenterology: American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease
- American Gastroenterological Association: Understanding Heartburn and Reflux Disease
- FamilyDoctor.org: Heartburn Treatment