Beat heartburn and soothe your stomach

Does indigestion have you popping pills? Here are the right ones to take and some other options to try

Last updated: September 2008

When you feel that burning sensation in your chest after overindulging, you probably run to the medicine cabinet. Heartburn (aka acid reflux, dyspepsia, or just plain indigestion) is common--about 20 percent of people suffer from it at least once a week; another 20 percent get it at least occasionally. There are plenty of pills that claim to beat the burn, but read this before you pop another one.

The burning sensation is caused by stomach acid backing up in your esophagus. Normally, strong involuntary contractions keep everything moving down into the stomach and a powerful muscle called the lower esophageal sphincter keeps it there. But if that sphincter isn’t closing properly, acids can flow backward, or reflux, and they can irritate, inflame, and even erode your esophageal lining. Attacks may come after meals or in the middle of the night. Over time, the irritation can affect the voice box and windpipe, leading to wheezing, coughing, hoarseness, or a chronic sore throat. Frequent bouts of heartburn could lead to a diagnosis of gastroesophageal reflux disease. And eventually that can cause such illnesses as bronchitis, pneumonia, and even esophageal cancer.

So see a doctor if you have severe or frequent heartburn. For occasional bouts, see the six dos and don’ts of heartburn relief before reaching for any meds.

What to take and when

If changing the way you sleep or eat doesn't work, meds are the next step. See a doctor, though, if you need a heartburn drug daily for two weeks, or several times a week for three months, or if you have a nagging cough or a sore throat, especially if you're pregnant.

When to take them
If you get mild heartburn attacks occasionally and unexpectedly.

How they work
Most antacids contain ingredients that quickly neutralize acid in the esophagus and control heartburn for up to a few hours. Some antacids wear off quickly, but Mylanta Ultimate Strength Chewables is the longest-acting. To save money, try lower-cost generic versions, which are just as effective as name brands.

When to take them
If you know that you're going to get heartburn in certain situations, like when you eat pizza. Take them an hour before you're about to eat a meal that's likely to trigger an attack. They all start working within 30 minutes to an hour, and one dose can last up to 12 hours, but you may have to down a pill every day at first. Pepcid Complete combines an antacid with an H-2 blocker for both immediate and longer-term relief.

How they work
They block stomach-acid production. But they aren't strong enough for chronic heartburn.

When to take them
If you get heartburn more than once or twice a week. Studies have shown that PPIs like Prevacid, Prilosec, Nexium, and AcipHex work better than H-2 blockers. But they're ineffective for occasional heartburn.

How they work
They completely block the mechanism that releases stomach acid, but it can take several days for them to work. Most are dispensed by prescription only. You can buy one, Prilosec OTC, over the counter. (The generic version is omeprazole.) If you're pregnant, talk to your doctor before taking Prilosec.

This article first appeared in the August/September 2008 issue of ShopSmart.


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