Information about heartburn and warning signs when it might not be heartburn. Includes info on both prescription and non-prescription meds.
Do you avoid tomato sauce, orange juice, and deep-fried foods because they trigger a burning pain behind your breastbone or in your throat? Sounds like you need some tips on banishing heartburn, also known as acid indigestion.
According to gastroenterologists, heartburn occurs when digestive juices splash up into the esophagus, the tube that leads from the mouth to the stomach. This backflow brings with it harsh acids that burn tender tissues, causing pain, inflammation, and sometimes more serious complications.
The cause of the backflow is usually an open sphincter muscle in the esophagus. The muscle normally acts like a valve to shut out stomach acid, but when it isn't working properly, acid can slip up.
Often you can control heartburn with a combination of smart self-care and wise medication use. But if you experience heartburn two or more days a week on a continuing basis, consult a health professional. You may have a more severe form of heartburn known as gastroesophageal reflux disease (GERD).
In addition, because other conditions, such as ulcer or gallbladder disease, can mimic heartburn's symptoms, you should see a doctor if discomfort lasts more than two weeks or is accompanied by abdominal pain.
And if you have heartburn along with pain in the chest or arms, shortness of breath, weakness, dizziness, irregular pulse, or sweating, contact a doctor immediately. You could be having a heart attack.
1. Eat smaller meals and chew food well to reduce stomach acid secretion.
2. Wait two to three hours before lying down after eating.
3. Raise the head of your bed six inches, so digestive juices won't flow up while you sleep.
4. Avoid coffee, alcohol, and acidic, fried, and spicy foods.
5. Relax. Stress can boost acid secretion.
6. Ask your doctor or pharmacist if heartburn may be a side effect of another medication.
Antacids: Made with at least one of four key ingredients--sodium bicarbonate, calcium, magnesium, and/or aluminum--these over-the-counter (OTC) acid neutralizers work quickly if taken at the first sign of distress. But they must be taken frequently (every one to three hours) for long-lasting comfort.
H2 Blockers: H2 blockers slow the secretion of stomach acids and in some cases prevent their production altogether. Several formerly prescription-only acid reducers are now also available in lower-dose OTC formulations: nizatidine (Axid AR), famotidine (Pepcid AC), cimetidine (Tagamet HB), and ranitidine (Zantac 75).
Proton Pump Inhibitors: The most powerful acid suppressants are prescription medications called proton pump inhibitors. These include omeprazole (Prilosec) and lansoprazole (Prevacid). Proton pump inhibitors almost completely shut down gastric acid secretion by suppressing an enzyme necessary for its production. This helps relieve pain and heal tissue irritation.
The Food and Drug Administration (FDA) recently warned doctors to try every other alternative before prescribing the heartburn drug cisapride (Propulsid). According to the FDA, Propulsid may interact dangerously with many other medications (see possible drug interactions below). The drug should also be avoided by those with congestive heart failure, chronic obstructive pulmonary disease, advanced cancer, and certain other conditions.
Possible Drug Interactions
Here are some drugs or foods that may interact with, decrease, or increase the effects of the medication you're taking: Antacids can reduce the absorption of many other oral drugs, including some antibiotics, analgesics, heart and blood pressure medications, iron supplements, and oral anti-yeast drugs.
Some researchers think certain H2 blockers magnify the absorption and effect of alcohol. Consult your doctor before taking H2 blockers if you are taking ketoconazole (Nizoral) or Diflucan. Consult your doctor before using cimetidine (Tagamet and Tagamet HB) if you are also taking warfarin (Coumadin), theophylline, or phenytoin (Dilantin and some other seizure medications).
Prevacid may interfere with the absorption of drugs that rely on stomach acids to break them down, including ketoconazole; some antibiotics such as Ampicillin; iron supplements; and digitalis preparations.
Prilosec may interact with Ampicillin-containing antibiotics, cyclosporine (Sandimmune), diazepam (Valium), iron supplements, ketoconazole (Nizoral), phenytoin (Dilantin), and warfarin (Coumadin).
Propulsid can interact dangerously with many drugs, including but not limited to antibiotics such as clarithromycin (Biaxin), erythromycin, troleandomycin (Tao), and sparfloxacin (Zagam); antidepressants such as nefazodone (Serzone); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and oral ketoconazole (Nizoral); the protease inhibitors indinavir (Crixivan), and ritonavir (Norvir); the antihistamine astemizole (Hismanal); and antiarrythmia medications such as procainamide (Procanbid), quinidine (Quinaglute Dura-Tabs), and sotalol (Betapace).