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Take Heartburn Medicines Before Breakfast

Too many patients unaware that timing is key to treatment, study finds

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In a previous study, only one-third of primary care doctors told patients to take the medicines before meals, but nearly all gastroenterologists did, according to the report.

In his study, Wolfe found, the severity and frequency of symptoms were better in those who were prescribed the drug by a gastroenterologist compared to a primary care doctor.

"If you have frequent heartburn, you have a disease, GERD," Wolfe said. "And you really should see a physician and not treat yourself," he explained.

Dr. John Lipham is director of the Digestive Health Center at Keck Medicine of the University of Southern California. Lipham reviewed the findings but was not involved in the study.

"It's something we have known since these medications came out, that they work best if you take them 30 minutes or so before a meal," said Lipham.

However, he pointed out that the new study puts some data behind what experts knew from experience.

Lipham said the new study is the first, to his knowledge, to show a difference in taking the medicine correctly depending on who prescribed it.

Wolfe and Lipham both find that patients often think of the proton pump inhibitors in the same way as antacids, meant to be taken when heartburn strikes.

"But these [proton pump inhibitor] medicines don't work that way," Lipham said. "They need to be stimulated by acid and need to build up in your system. You have to take them at the correct time each day and you also need to take them every day to get the maximum effectiveness of the medications."

As to why doctors aren't all telling their patients how to use these drugs, Wolfe speculated that primary care doctors may be too busy and don't have the time to read all of the drug literature.

The bottom line is "it boils down to education," said Wolfe. Physicians and consumers need to take the time to learn about the drugs.

Ideally, Wolfe said, you should take the medicine in the morning, then ''eat something that causes your stomach to make acid, such as protein, an egg, a piece of cheese, yogurt." For those who hate breakfast, he advises drinking a glass of milk or at least a cup of coffee.

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