Heartburn happens when stomach acid flows backward, up into your esophagus—the tube that carries food from your mouth to your stomach. Sometimes, partially digested food flows all the way to the back of your throat. This backward flow is called reflux.
If you have heartburn, you don’t need to suffer in silence. Don’t hesitate to ask your pharmacist questions about heartburn, and the lifestyle changes and prescription and over-the-counter (OTC) medications that can provide relief. He or she can be your partner in treatment.
Use this checklist to decide whether you have heartburn or a more serious condition.
IS IT HEARTBURN?
- After meals—or after eating certain foods—do you sometimes feel a warmth or pain at your breastbone? Yes No
- Do you sometimes have an acid taste in the back of your throat? Yes No
- Do you ever feel that food is coming back into your mouth? Yes No
- When you lie down, especially after a large meal, do you get these feelings? Yes No
- Do these feelings go away when you take antacids or OTC acid blockers? Yes No
If you can answer yes to any of these five questions, then you have heartburn—but read on.
IS IT MORE THAN HEARTBURN?
- Is your heartburn severe? Yes No
- Do you have heartburn two or more times each week? Yes No
- Has it lasted for several months? Yes No
- Do you regularly take medications for it—and it still comes back? Yes No
If you can answer yes to any of these last four questions, you may have a more serious problem.
Talk to your primary health care provider.
Three Myths About Heartburn
Myth #1: Heartburn is no big deal.
Fact: Heartburn pain can severely limit what you do and how well you do it. Your health care provider or pharmacist can help you treat it.
Myth #2: My heartburn is my own fault.
Fact: You didn’t cause your heartburn, but you can take a number of steps to lessen its pain and inconvenience.
Myth #3: Heartburn is not a serious medical problem.
Fact: Heartburn can progress to cause more serious problems including these two:
- Inflammation and ulcers in your esophagus.
- A change in the cells of the esophagus lining.
Never ignore severe or persistent heartburn. Contact your health care provider. He or she can do tests to find out whether your heartburn has led to any more serious health problems.
Four Ways to Get Your Heartburn Under Control
The causes of heartburn vary from person to person. These suggestions may help you discover what your personal triggers are.
Watch what and how you eat.
- Avoid certain foods. Be cautious about eating citrus fruits, tomato products, fatty or greasy foods, chocolates, peppermints, vinegar, spicy foods, garlic, raw onions, and black or red pepper.
- Stay away from certain beverages—especially on an empty stomach. The drinks most likely to cause heartburn include coffee, tea, carbonated drinks, citrus drinks and juices, tomato juice, and alcohol.
- Eat smaller, more frequent meals rather than three large meals each day.
- For 2 to 3 hours after eating, avoid lying down, bending over repeatedly, or doing vigorous exercise.
Change your sleeping routine.
- Raise the head of your bed at least 6 inches using a mattress wedge or blocks; don’t use pillows.
- Do not eat or snack within 2 to 3 hours before going to bed.
Change your habits.
- If you smoke, stop.
- If you are overweight, lose weight—but be sure to consult your health care provider before starting a vigorous exercise program.
- Avoid tight-fitting, restrictive clothes.
Know your reaction to your medications.
- One of your prescription or OTC medications may cause heartburn.
- Ask your pharmacist or health care provider about alternatives— but never stop taking a prescription medication on your own.
Medications Can Give You Relief
Some people are confused by the large number of heartburn medications available. Matching your symptoms to the proper medication is important.
Do you get heartburn just every once in a while?
Try an OTC medication.
An OTC medication, such as an antacid or H2 blocker, may work well for you. Your pharmacist can help you choose among the available products.
Antacids neutralize stomach acid. They work quickly and give temporary relief that lasts 1 to 2 hours. Some brands are Tums®, Maalox®, and Mylanta®.
H2 blockers reduce the amount of acid your stomach makes. They give relief that lasts 6 to 12 hours. Some brands are Tagamet HB®, Pepcid® AC, Axid® AR, and Zantac 75®.
Do you get heartburn 2 or more days a week?
Change your OTC medication.
This type of heartburn is called frequent heartburn. To treat it, you might need a medication called a proton pump inhibitor (PPI). One PPI, Prilosec OTC™, is now available without a prescription. Prilosec OTC™ is the only OTC medication indicated specifically for frequent heartburn. When taken as directed for 14 days, it provides 24-hour relief of frequent heartburn symptoms. If symptoms persist longer than 14 days, you should see your health care provider.
Do you need more help than OTC medications can provide?
You may need a prescription medication.
For prescription PPIs (including Prilosec®, Prevacid®, Aciphex®, Protonix®, and Nexium®), you will need to contact your health care provider. Prescription PPIs block your stomach’s production of nearly all acid, leaving just enough for normal digestion of food. Another type of prescription medicine, sold under the brand name Reglan®, helps the stomach empty faster, leading to less acid reflux.
When to Ask for Help
You may hesitate to contact your primary health care provider about heartburn. However, if lifestyle changes and OTC medications don’t ease your discomfort, your health care provider can offer several other treatment options. Your pharmacist can help you decide whether further medical help for your heartburn is necessary.
This checklist will help you know when to make the call.
SHOULD YOU CALL YOUR PRIMARY HEALTH CARE PROVIDER?
- Have your symptoms lasted for more than 14 days? Yes No
- Do your symptoms continue even after you take OTC heartburn medication? Yes No
- Does heartburn or reflux wake you from sleep? Yes No
- Do you often have a sore throat, severe hoarseness, or wheezing? Yes No
- Are you bothered by nausea or vomiting? Yes No
- Have you noticed an unexplained weight loss? Yes No
If you can answer yes to any of these questions, make an appointment with your health care provider—but read on.
SHOULD YOU SEEK HELP RIGHT AWAY?
- Is swallowing difficult or painful? Yes No
- Are you vomiting blood or noticing blood in your stool? Yes No (Blood in vomit can look like coffee grounds. Blood from the stomach that appears in the stool may be black or tarry looking.)
If you can answer yes to either of these questions, see your health care provider immediately.
To learn more about heartburn—