Occasional heartburn is common, but when it sticks around, many of us reach for the medicine cabinet.
But is heartburn medication a good long-term solution? We asked Gena Cobrin, MD, a gastroenterologist with Hartford HealthCare’s Digestive Health Institute, for guidance.
Stomach acid is the heartburn culprit.
You may feel heartburn in your chest, but it all starts in your stomach.
“Heartburn is a burning sensation in your chest that occurs when stomach acid backs up into your esophagus,” explains Dr. Cobrin. “This backing up of acid is also called gastroesophageal reflux.”
Various things can cause heartburn, including:
- Non-modifiable factors, like age
- Various health conditions
- Lifestyle factors
- Medications
Heartburn may come and go for many of us, but Gastroesophageal Reflux Disease (GERD) is a long-lasting condition. And repeated reflux symptoms can lead to complications over time.
> Related: 4 Home Remedies for Heartburn That Actually Work
If you have acid reflux, you probably use one of these 4 types of medication.
“There are four categories of acid reflux medication, which can be used separately or together depending on the severity of your symptoms,” says Dr. Cobrin.
These medications include:
- Antacids provide immediate, temporary relief when you’re experiencing acid reflux, but they don’t prevent it. (Examples include Tums, Rolaids, Mylanta and Alka-Seltzer).
- H2RAs (histamine 2 receptor antagonists) reduce the acid produced in your stomach and provide longer-lasting relief than antacids. (Examples include Pepcid AC or Zantac 360).
- PPIs (proton pump inhibitors) also reduce stomach acid, but they do so by stopping proton pumps from releasing acid and providing longer relief than H2RAs. (Examples include Prilosec, Nexium or Prevacid).
- PCABs (potassium-competitive acid blockers) are a newer form of acid reflux medication that targets proton pumps and offers an alternative for people who don’t respond well to other medicines.
But long-term use of heartburn medication can have its risks.
If you’ve graduated to protein pump inhibitors like Prilosec, Nexium or Prevacid, it’s important to know the potential long-term risks. These include:
- Osteoporosis and fractures
- Magnesium malabsorption and vitamin B12 deficiency
- Clostridium difficile associated disease (CDAD), an infection of the colon
If you have a condition like Barrett’s esophagus, which requires long-term acid suppression, your gastroenterologist can help you navigate medication safely.
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Lifestyle changes can help you treat heartburn naturally.
Medication is a very effective treatment for heartburn, but lifestyle changes can also help improve symptoms, without any risks.
“We first encourage patients to focus on dietary and lifestyle modifications to decrease reflux,” says Dr. Cobrin.
Simple changes can help, such as:
- Weight loss.
- Avoiding/minimizing tobacco, alcohol and caffeine.
- Eating small meals.
- Not eating late at night.
“We always try to maintain the patient on the lowest possible dose of medication while controlling the patient’s symptoms,” explains Dr. Cobrin. “Check in regularly with your gastroenterologist to see if you can lower the dose or stop your medications.”
Not sure what’s right for your acid reflux?
“Your doctor is your best resource,” says Dr. Cobrin. “They can recommend dietary and lifestyle modifications, medication, surgery or a combination of therapies to help you.”
And be sure to rule out heart conditions, which can be confused with heartburn.
While Dr. Cobrin says a little heartburn now and then is nothing to worry about, it can sometimes be confused with cardiac symptoms.
“Speak to your doctor to rule out a cardiac source if appropriate,” she adds. “It’s also important to discuss all your symptoms with your healthcare provider so we can get you the right tests and best care plan.”