The Dos and Dont's of Treating Heartburn

Published: September 02, 2021
By Douglas Lasch, Pharm.D. Candidate, Class of 2022

Heartburn, also called indigestion or sour stomach, is a common gastrointestinal problem that can affect daily activities, limit food choices, and cause sleep disturbances. General heartburn symptoms include pain or burning in the stomach or lower chest that rises toward the neck. This may be accompanied by an early feeling of fullness or bothersome amount of fullness after eating, nausea, vomiting, abdominal bloating or belching. For occasional or mild cases of heartburn, your pharmacist can help guide you through diet or lifestyle changes to prevent symptoms from returning.

What causes heartburn?

  • Foods, especially those that are spicy, acidic (tomato-based or citrus), high in fat or sugar, caffeinated or carbonated beverages, alcohol, coffee, or juice
  • Medications including non-steroidal anti-inflammatory drugs, antibiotics, opioid pain relievers, or chemotherapy
  • Movement such as laying down after a meal, lifting heavy objects, or over-exercising
  • Lifestyle factors such as smoking, obesity, genetics, stress, or tight-fitting clothing

How can I treat heartburn?

Occasional episodes of heartburn can be treated with over-the-counter (OTC) medications and/or diet and lifestyle changes. Keep in mind the following if you choose to treat it yourself:

  • DO talk to your pharmacist about your symptoms and current medications. There are many OTC medications available. Your pharmacist will help find the best option for you.
  • DO consider lifestyle changes that may help relieve your symptoms. Lifestyle changes can be done alone or in combination with an OTC medication.
  • DO seek medical attention if you experience any of the following: difficulty swallowing, vomiting blood, black or tarry stools, unexplained weight loss, radiating chest pain, no relief after two weeks of treatment.
  • DO NOT stop taking medications that you believe may be causing your heartburn. Talk to your doctor first.
  • DO NOT start taking multiple OTC medications at once, unless directed by a medical professional. These medications may cause further problems when taken together

Lifestyle changes that may help reduce your symptoms include:

  • Identifying and avoiding foods that cause or worsen your heartburn
  • Eating smaller meals
  • Trying not to eat three hours or less before you lay down
  • When laying down, elevate your head and chest by at least six inches using pillows or foam wedges.
  • Talking to your doctor about a weight loss and exercise regimen.

Available OTC medications include:

  • Antacids (Alka-Seltzer, Gaviscon, Mylanta, Pepto-Bismol, Tums) – Reduces acidity in the stomach to immediately relieve mild heartburn.
  • Histamine-2 receptor antagonists (famotidine [Pepcid, Zantac 360]) – Decreases stomach acid to relieve heartburn at night; most effective if taken daily.
  • Proton pump inhibitors (omeprazole [Prilosec]; lansoprazole [Prevacid]; esomeprazole [Nexium]) – Decreases production of stomach acid to relieve heartburn but does not have an immediate effect like antacids to neutralize the acid in your stomach; most effective if taken daily, however, do not take for more than 14 days or more often than every four months unless directed by your doctor.

Summary

Your pharmacist will recommend OTC medications and lifestyle changes that will work best for you based on the frequency, duration, and severity of your heartburn symptoms. Pharmacists are a great, accessible resource and are always happy to help.

Be sure to visit your doctor if you experience difficulty swallowing, vomiting blood, black or tarry stools, unexplained weight loss, radiating chest pain, or no relief after two weeks of treatment. Your heartburn could be a sign of a bigger issue, such as gastroesophageal reflux disease, peptic ulcer disease, or other gastrointestinal disorders that require help from a doctor.

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