Heartburn and Gastroesophageal Reflux Disease (GERD)
Over-the-Counter Heartburn Treatments
Antacids. Antacids neutralize excess stomach acid to relieve heartburn, sour stomach, acid indigestion, and stomach upset. They are also occasionally recommended to help relieve the pain of ulcers. Some antacids also contain simethicone, an ingredient that helps eliminate excess gas. Examples of antacids include: Tums, Rolaids, and Maalox. You should take antacids exactly as directed by your doctor, or according to the manufacturer's directions. If you are using the tablets, chew them well before swallowing for faster relief. Serious side effects can occur with an overdose or overuse of antacids. Side effects include constipation, diarrhea, change in color of bowel movements, and stomach cramps.
Acid Blockers. These medicines relieve heartburn, acid indigestion, and sour stomach, and are available without a prescription. Pepcid AC, Tagamet HB, Zantac 75, Axid AR, Nexium 24HR, and Prilosec OTC are examples of over-the-counter acid blockers. Acid blockers work by reducing the production of stomach acid. Take these medications according to the directions on the package, or as advised by your doctor. Possible serious side effects that need to be reported to your doctor right away include confusion, chest tightness, bleeding, sore throat, fever, irregular heartbeat, weakness, and unusual fatigue. Other less serious side effects include mild headache, dizziness and diarrhea, which are usually temporary and will likely go away on their own.
People who have more severe heartburn symptoms that aren't relieved with these medications or who have been using these drugs for more than two weeks should contact their doctor. They may need a prescription drug.
Prescription Heartburn Treatments
H2 Blockers. Histamine-2 (H2) blockers such as Pepcid, Tagamet, Zantac, and Axid work by reducing the production of stomach acid. The prescription forms of these medications (which usually contain higher doses than the over-the-counter versions) can generally relieve heartburn and treat GERD. They also may be used for other conditions as determined by your doctor.
Proton Pump Inhibitors. Depending on the source of your problem, your doctor can prescribe medications that block acid production more effectively than the H2 blockers. PPIs include Prilosec, Prevacid, Aciphex, Protonix, and Nexium. Another PPI product combines Prilosec with sodium bicarbonate (Zegerid).
Promotility Agents. Promotility agents work by speeding up digestion, which prevents acid from staying in the stomach too long, and strengthening the lower esophageal sphincter, reducing reflux back up into the esophagus. Reglan is a promotility agent occasionally used to treat heartburn associated with GERD. The side effects of Reglan may include drowsiness, fatigue, diarrhea, restlessness, and movement problems. Another promotility agent, Propulsid, was removed from the market in 2000 because it caused serious heart arrythmias (abnormal heart beat) in some people.
Most patients are successfully treated with these medications. Only a few people need surgery to correct the disorder.