
Heartburn Treatment
If you’ve ever felt like your chest was on fire after eating a big or greasy meal, then you’re probably familiar with heartburn. Whether it happens to you occasionally or more often, you can take simple steps to soothe the burn. Learn more about why heartburn happens, who’s at risk, and how to stop -- and prevent -- the pain.
Medication for Heartburn
Several types of over-the-counter (OTC) and prescription medicines can help with heartburn. Your doctor or pharmacist can help you find the one that’s right for you.
Types of medicine |
How they work |
How fast they start working |
How long the effects last |
Side effects |
Antacids
|
They neutralize stomach acid. |
Within seconds |
Up to 3 hours |
Some cause constipation and diarrhea. |
H2 Blockers
|
They lower the amount of acid your stomach makes. |
In about 30 minutes |
Up to 12 hours |
They may cause constipation, diarrhea, headache, nausea, or vomiting.
|
Proton-Pump Inhibitors (PPIs)
|
They lower the amount of acid your stomach makes. |
Up to 4 days |
Up to 24 hours |
They may cause diarrhea, headache, stomach pain, nausea, or vomiting.
|
|
|
|
|
|
Antacids
Soothe occasional, mild heartburn with an antacid that contains calcium carbonate or magnesium. They help zap stomach acid. Some prevent acid reflux. Those that contain magnesium may also help heal stomach ulcers. They come in liquids and pills and are fast-acting.
Antacids can cause constipation and diarrhea. Look for brands that contain calcium carbonate, magnesium hydroxide, and aluminum hydroxide to reduce these side effects. Don’t take antacids with magnesium if you have chronic kidney disease. Some antacids have a lot of salt, so you should take them only for occasional heartburn.
H2 Blockers
H2 blockers help relieve and prevent occasional heartburn by lowering the amount of acid your stomach makes. Though they don’t work as fast as antacids, their effects last longer. Your doctor may tell you to take an antacid and an H2 blocker together. H2 blockers are for short-term use -- less than 2 weeks. You can take them before your meals to prevent heartburn, or at bedtime. They come in liquids and pills.
All H2 blockers work about the same. So if one doesn’t help with your heartburn, switching to a different one isn’t likely to help. Changing to a higher-dose prescription version of the drug might help, though. Talk to your doctor if over-the-counter H2 blockers aren't working for you.
Some H2 blockers can interfere with other drugs, including:
- Antiseizure medicines
- Blood thinners
- Medicines for heart rhythm problems
Talk to your doctor if you take any of these medicines and you need to take an H2 blocker.
The most common side effects are mild and include:
- Constipation
- Diarrhea
- Headache
- Nausea or vomiting
Proton-Pump Inhibitors (PPIs)
PPIs are used to prevent frequent heartburn that happens more than twice a week. They work by lowering the amount of acid your stomach makes. Often, they work better than H2 blockers. You also can take these drugs for a longer period of time than H2 blockers.
PPIs are available over the counter and by prescription. But if you have gastroesophageal reflux disease (GERD), when stomach acid flows back into the tube connecting your stomach and mouth, you may need prescription-strength medication.
You need to take PPIs once a day on an empty stomach so they’ll work best. Usually you’ll take the medicine every morning, about 30 to 60 minutes before you eat breakfast, to control stomach acid.
Talk to your doctor before taking the PPI called omeprazole if you take clopidogrel, a drug used to prevent heart attacks and strokes. Taking the two drugs will make clopidogrel less effective.
The most common side effects of PPIs are mild and include:
- Diarrhea
- Headache
- Nausea and vomiting
- Stomach pain
PPIs may also raise your chances of getting an infection of the intestines or lungs, but this is rare. These medicines have also been linked to fractures of the hip, wrist, and spine. The risk is highest in people who take PPIs for a year or more.
Prokinetics
Prokinetics help your stomach empty faster, so you have less acid left behind. Usually you take this medicine before meals and at bedtime.
Prokinetics are sold only by prescription.
Prokinetics can have more serious side effects than PPIs or H2 blockers. These include:
- Anxiety
- Depression
- Diarrhea
- Drowsiness
- Fatigue
- Irritability
- Nausea
- Problems with movement
Medical Heartburn Treatment
If your heartburn isn’t getting better, your medicines cause side effects you can’t handle, or you have other complications, you may need surgery. It is rare to need surgery for heartburn.
There are several different procedures that can reinforce the valve between your esophagus and stomach to keep acid from coming back up. The one used most often is called fundoplication. The surgeon wraps the top part of your stomach around the lower esophagus to increase pressure on the muscle that opens and closes it. There are modified versions of this, too.
The surgery is normally done as a laparoscopy, which requires only small cuts in your abdomen and a short hospital stay.
When is heartburn an emergency?
Heartburn is usually a minor problem that goes away over time. But if you also have other symptoms, it could be a sign that something more serious is wrong. Call your doctor or go to the emergency room if:
- It hurts to swallow
- You feel like you’re choking
- You have black, tarry-looking bowel movements
- Your mouth or throat hurt when you eat
- Your voice is hoarse
- Your vomit contains blood or what looks like coffee grounds
- You have trouble breathing
Is it heartburn or a heart attack?
Heartburn doesn’t affect your heart, but it can feel a lot like the chest pain that happens during a heart attack. Call 911 if you have any of these symptoms along with chest pain, even if you’re not sure that you’re having a heart attack:
- Dizziness
- Nausea and vomiting
- Pain that travels to your neck and shoulder, jaw, or back
- Shortness of breath
- Sweating
Heartburn Home Remedies
You can also make changes to your diet and lifestyle to help manage your heartburn. You might have noticed that it gets worse when you eat or drink certain things. Here are a few that can trigger heartburn:
- Alcohol
- Chocolate
- Coffee
- Fatty or fried foods
- Greasy foods
- Onions
- Oranges, lemons, and other citrus fruits and juices
- Peppermint
- Sodas and other bubbly drinks
- Spicy foods
- Tomatoes and tomato sauce
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