How Heartburn Is Treated – Verywell Health

Jay Yepuri, MD, MS, is a board-certified gastroenterologist and a practicing partner at Digestive Health Associates of Texas (DHAT).
Heartburn, also referred to as acid reflux, occurs when stomach acid comes into contact with the lining of the esophagus (feeding tube). This can occur when the lower esophageal sphincter (LES)—the muscle that prevents the backflow of stomach acid into the esophagus—is not working properly.

Most people experience heartburn occasionally, but some have more frequent or serious heartburn symptoms. Depending on the frequency and severity of your symptoms, the treatment options can vary.
Verywell / Jessica Olah
This article looks at the various treatments for people with occasional heartburn, including home remedies, lifestyle changes, over-the-counter medications, prescription drugs, and complementary therapies.

Though heartburn is related to gastroesophageal reflux disease (GERD), the terms are not interchangeable. GERD is a more severe, chronic form of acid reflux, while heartburn is essentially a symptom of acid reflux and GERD.
For the purpose of this article, the information will be mainly focused on the treatment of occasional heartburn.
You can alleviate heartburn by avoiding food that causes heartburn and making other lifestyle choices that can minimize heartburn symptoms.
Nicotine in cigarette smoke relaxes the lower esophageal sphincter. Smoking also stimulates the production of stomach acid. If you suffer from heartburn, stop smoking and avoid secondhand smoke as well.
Being overweight or obese places pressure on the abdomen and increases the risk of heartburn. Heartburn is one of many health reasons why you should aim for a healthy body mass index (BMI) of 30 or lower.
It also helps to loosen the waistband if you have regular heartburn. Anything that compresses the abdomen can directly affect the function of the esophagus. Opt instead for loose-fitting clothes when occasional heartburn strikes.
Some common heartburn triggers can be avoided in the following ways:
Create a heartburn-friendly diet by keeping a food diary to record which foods are safe for you and which are more likely to trigger heartburn.
Beyond what you eat and drink, how and when you eat can also trigger heartburn symptoms. To avoid this:
Nearly 80% of people with heartburn experience heartburn at night. Besides avoiding food before bedtime, there are ways to avoid nocturnal acid reflux:
Certain lifestyle changes can help treat or prevent heartburn. These include quitting cigarettes, maintaining a healthy weight, identifying and avoiding trigger foods, sleeping with your head elevated, and eating smaller, more frequent meals.

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There are several over-the-counter (OTC) remedies for heartburn, some of which were only available by prescription a few years ago.
Antacids are commonly used to treat heartburn. They help relieve occasional heartburn and indigestion by neutralizing stomach acids.
Antacids are sold under the following brand names, each of which has slightly different formulations and/or ingredients:

Antacids can interfere with the absorption of certain drugs, including HIV medications. Speak with your doctor before using antacids to ensure they do not interact with any drugs you are taking.
People who are pregnant should not use antacids containing sodium bicarbonate or magnesium trisilicate as they can cause excessive fluid buildup and affect the development of the fetus.
H2 blockers, also known as H2-receptor antagonists, are medicines that reduce the amount of acid in the stomach. They block a chemical called histamine-2 (H2) that stimulates acid-producing cells in the stomach.
H2 blockers are sold under the following brand names:
Side effects are uncommon but may include headache, diarrhea, fatigue, and dizziness.
Proton pump inhibitors (PPIs) also block the production of stomach acid, albeit in a different way. They do so by shutting down a system known as the proton pump that is integral to the production of stomach acid.
Over-the-counter PPIs include:
PPIs are generally taken for two weeks and should not be used for an extended period of time.
Side effects include headache, diarrhea, constipation, stomach upset, cough, hoarseness, nausea, and vomiting.
Over-the-counter medications frequently used to treat heartburn include antacids like Tums and Rolaids, H2 blockers like Tagamet and Pepcid, and proton pump inhibitors (PPIs) like Nexium and Prilosec.
If OTC medications and lifestyle changes fail to control heartburn, your doctor may recommend prescription versions of H2 blockers and PPIs.
Besides the OTC-strength H2 blockers, there are versions of Axid (nizatidine), Pepcid (famotidine), and Tagamet (cimetidine) available by prescription as well as an H2 blocker called Protonix (pantoprazole).
Prescription H2 blockers are generally more effective than their OTC version but are also more likely to cause side effects. These are intended for the short-term relief of severe heartburn only.
Prescription PPIs are available under the following brand names:
Prescription PPIs are meant to be taken under a healthcare provider's supervision and only for a limited time. The chronic use of PPIs is associated with an increased risk of bone fractures, kidney disease, and heart attacks.
When OTC medications and lifestyle changes fail to provide heartburn relief, there are H2 blockers and PPIs available by prescription that can help. These are intended for short-term relief of severe heartburn symptoms only.
There are several complementary therapies people use to treat heartburn. The evidence supporting their use is limited, so speak with your doctor to ensure that they are safe and don't interfere with any of the medications you are taking.
Baking soda, also known as sodium bicarbonate, is a natural antacid. If you dissolve a teaspoon of baking soda into 8 ounces of water and drink it, it may help neutralize stomach acid and temporarily ease heartburn. Side effects include burping and bloating.
Sodium bicarbonate may decrease the effectiveness of aspirin. It should also not be used in people who are pregnant due to the risk of abnormal fluid build-up.
Aloe vera juice has been used in traditional medicine to treat esophageal irritation. While it is unwise to use unprocessed aloe vera (as it has potent laxative effects), there are some products that are specially formulated for internal use.
This includes AloeCure, a formulated remedy containing organic processed aloe juice. Marketed as an all-natural remedy for digestive disorders, AloeCure was found to relieve heartburn in several smaller studies.
Aloe vera should be avoided in people on anti-diabetes medications as it can lower blood sugar and cause hypoglycemia. Aloe vera can also interact with blood thinners like Coumadin (warfarin) and Plavix (clopidogrel), increasing the risk of easy bruising and bleeding.
Deglycyrrhizinated licorice is a natural remedy that is sometimes used to soothe heartburn and other digestive ailments.
On its own, licorice can raise blood pressure and cause undesirable side effects. By contrast, deglycyrrhizinated licorice has the ingredient responsible for this effect (called glycyrrhizic acid) removed.
Some studies suggest that deglycyrrhizinated licorice (including a formulated product called GutGard) is useful in relieving occasional heartburn and indigestion.
Despite having few side effects, deglycyrrhizinated licorice can interact with diuretics, corticosteroids, or other medications that lower the body’s potassium level. Taking them together can cause a potentially severe drop in blood potassium known as hypokalemia.
Complementary therapies used to treat heartburn include baking sodium (sodium bicarbonate), aloe vera, and deglycyrrhizinated licorice. While several smaller studies have suggested they can help, the evidence supporting their use is limited.
Occasional heartburn (acid reflux) can be often be treated or prevented with lifestyle changes such as quitting cigarettes, maintaining a healthy weight, avoiding food triggers, eating smaller meals, and sleeping on your left side or with your head elevated.
Over-the-counter antacids, H2 blockers, and proton pump inhibitors (PPIs) are also effective in relieving occasional heartburn. People with severe heartburn may require prescription H2 blockers or PPIs to control their symptoms. Medications like these are intended for short-term use only.
Complementary and alternative medicines (CAM) like baking soda, aloe vera, and deglycyrrhizinated licorice have been used to treat occasional heartburn, but the evidence supporting their use is weak.
Heartburn may last anywhere from just a few minutes to several hours. For some, it's an occasional occurrence; for others, it may occur frequently. Make an appointment to see a doctor if you have heartburn more than twice weekly.
Over-the-counter antacids, like Tums, Mylanta, or Rolaids, work by neutralizing stomach acid and are a good option for rapid, short-term relief.
Try eating yogurt or drinking milk. Adding a tablespoon of honey into warm milk may also be helpful. Some ingredients in antacids are not recommended during pregnancy, so speak with your doctor before using any over-the-counter heartburn medication.
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