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America Asks About Heartburn & GERD

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The Secrets of Managing GERD and Heartburn

Is it time to get serious about your GERD?

GERD Treatments: Medications continued...

“The proton pump inhibitors are a terrific class of medications,” says Rao. “They’re very effective, and they appear to be quite safe.” They’re even helpful in diagnosing GERD, Rao says. If they work, you probably have GERD. If they don’t, you probably have something else.

Like any medication, they can have side effects. There’s some concern that they may cause a small increase in the occurrence of weakened bones in older people. While the benefits of well-controlled GERD generally outweigh this risk, you should discuss it with your doctor.

  • H2 blockers. These come as prescription and OTC medicines. They include drugs like Axid, Pepcid, Tagamet, and Zantac and were once the standard treatment for GERD. But they’re not used as often now. “They’re perfectly good medicines,” says J. Patrick Waring, MD, a gastroenterologist at Digestive Healthcare of Georgia in Atlanta and a board member at the International Foundation for Functional Gastrointestinal Disorders (IFFGD.) “But H2 blockers just aren’t as powerful as the proton pump inhibitors.”

Some doctors still recommend them as GERD treatment, at least for mild cases. They’re also sometimes added to PPIs to help treat occasional breakthrough symptoms. Cheskin tells WebMD that H2 blockers may have one significant advantage. Because most are generic, they can be less expensive than PPIs.

  • Antacids. The old standbys from your grandparents’ medicine cabinet -- tablets like Tums and Rolaids and liquids like Maalox and Mylanta -- can still play a role in controlling GERD. These heartburn remedies aren’t suited for regular, long-term use. But their main advantage is that they work quickly, unlike more powerful GERD medications.

“If you’re suffering with heartburn after drinking or eating a big spicy meal, a proton pump inhibitor is not going to help,” Cheskin says. “But an antacid will.” Just as antacids offer heartburn relief to people without GERD, they can help GERD sufferers who have occasional breakthrough symptoms. 

  • Prokinetics. These prescription drugs -- like Reglan and Urecholine-- help speed up the emptying of the stomach. While they’re often mentioned alongside other GERD treatments, experts say that they’re rarely helpful. They might be of benefit to people who have GERD on top of another condition that’s slowing down their digestion. At the same time, prokinetics can have serious side effects.

Many potent drugs that were once only available by prescription -- like H2 blockers and the PPI Prilosec -- are now available over the counter. Experts say it’s fine for a person with occasional heartburn to use them, provided he or she follows the directions. Generally, they should never be used for more than two weeks.

GERD Treatments: Self-Care Tips

While drugs are often the main GERD treatment, there’s a lot you can do on your own. Here are some lifestyle tips for heartburn relief. 

  • Avoid trigger foods. Changing your diet can yield big benefits. Classic GERD triggers include chocolate, coffee, alcohol, peppermint, citrus juices, and tomatoes. The exact food triggers vary from person to person.
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