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Heartburn/GERD Health Center

Treatment Tips for Severe, Chronic Heartburn

If you have chronic heartburn or acid reflux, try these heartburn treatments from the experts.
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Over-the-Counter Antacids

Antacids like Maalox, Rolaids, and Tums can all work for occasional heartburn - although they may not be as effective for chronic heartburn.

"Digestion works with a cascade of different chemicals produced when you eat," says O'Brien, "which tell your stomach to produce stomach acid to help digestion." Antacids contain calcium, magnesium, or aluminum to neutralize excess stomach acid. But for chronic, severe heartburn, that may not be enough.

Acid Blockers for Heartburn and Acid Reflux

These drugs work by blocking how much stomach acid you produce. Not as fast-acting as antacids, these acid blockers last longer and can be effective for several hours at a time, says the AGA. Over-the-counter acid blockers include Axid, Pepcid, Tagamet, and Zantac. These brands are also available in prescription strength if the more mild forms don't bring enough relief.

These drugs work by blocking a type of histamine produced by your stomach, which in turn blocks acid production, says O'Brien. These histamine blockers are typically taken twice a day, 30 to 60 minutes before eating to be most effective, she says. Her advice: They're best used as a preventive measure, rather than sudden, fast relief of symptoms.

Proton Pump Inhibitors (PPIs) for Heartburn and GERD

Drugs called proton pump inhibitors, or PPIs, shut down tiny proton pumps in the stomach that produce acid, lowering acid levels dramatically. They're often used when histamine blockers don't provide enough relief or when you have erosions in the esophagus or other complications from GERD. One proton pump inhibitor, Prilosec, is available over the counter. Others, such as Aciphex, Nexium, Prevacid, Protonix, and stronger Prilosec require a doctor's prescription. Another PPI product consists of a combination of omeprazole and sodium bicarbonate (Zegerid). PPIs (except for Zegarid) are best taken an hour before meals.

There was some initial debate about whether PPIs were safe to take for long periods of time, O'Brien says. "There were concerns of things that might happen if you're constantly suppressing stomach acid," she says, "but studies show that it seems to be safe to use for an indefinite time."

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