Often described as a harsh, burning sensation in the upper abdomen, heartburn can radiate through the chest, and into the throat and neck. Other symptoms may also include regurgitation, difficulty swallowing and chronic coughing or wheezing.
Heartburn occurs when stomach contents leak back, or reflux, into the esophagus. The esophagus is the tube that carries food from the mouth to the stomach.
When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat that many call heartburn. The fluid may even be tasted in the back of the mouth; this is frequently called acid indigestion.
Heartburn that occurs once a month is considered mild. Heartburn once a week is considered moderate. And daily heartburn is considered severe. Heartburn that occurs more than twice a week may be considered gastroesophageal reflux disease (GERD), and it can eventually lead to more serious health problems.
Is it serious?
Mild to moderate heartburn usually is not a concern. However, if the heartburn becomes severe, problems such as swallowing difficulties, bleeding, or weight loss can develop. With GERD, a persistent inflammation of the lining of the esophagus occurs. GERD can lead to other health problems.
Persistent heartburn symptoms can be a sign of a more serious medical condition, such as severe inflammation of the esophagus or a tumor. It is important to be evaluated by your health professional if heartburn occurs more frequently and home treatment does not relieve the discomfort.
How is heartburn treated?
Home treatment measures and nonprescription medications are usually all that is needed to relieve mild to moderate heartburn discomfort.
Many of the recommended home treatment measures are the same as those recommended for people suffering from GERD:
- If you smoke, stop.
- Do not drink alcohol.
- Lose weight, if needed.
- Eat small meals.
- Wear loose-fitting clothes.
- Avoid lying down for 3 hours after a meal.
If these measures don’t take care of the problem, there are also a number of non-prescription medications available.
Your doctor may recommend over-the-counter antacids, which you can buy without a prescription:
Antacids, such as Maalox, Mylanta, Rolaids, and Riopan, are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Many brands on the market use different combinations of three basic salts–magnesium, calcium, and aluminum–with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, have side effects and should be used with care. Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects.
Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can also be a supplemental source of calcium. They can cause constipation as well.
Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.
Acid preventers. Several medications which used to be available only by prescription can now be purchased at pharmacies, without a prescription. They are not designed for occasional heartburn, but for more persistent forms of heartburn and GERD. We strongly recommend that you consult with a physician before using these on a long-term basis.
- H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time.
- Proton pump inhibitors include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are all available by prescription. Prilosec OTC is now available over-the-counter. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms in almost everyone who has GERD. Again, since persistent heartburn symptoms can indicate a number of more serious conditions, we strongly recommend discussing this medication with your physician before choosing to take it for an extended period of time.
What do I do now?
If the self-care measures listed above relieve your occasional heartburn symptoms, great! If your heartburn continues, or happens more frequently, you may have GERD and should consult a physician for further diagnosis.