Heartburn

Home Treatment

Home treatment, such as lifestyle changes and nonprescription medicines, may be all that is needed to treat mild to moderate heartburn. However, if your symptoms do not get better with home treatment, or if your symptoms occur frequently and last longer than 2 weeks, see your doctor to find out whether other medical conditions may be causing your symptoms.

Keep a record of your heartburn symptoms before and after making lifestyle changes or using nonprescription medicines so you can discuss any improvement with your doctor. See an example of a heartburn symptom record (What is a PDF document?).

Lifestyle changes to treat heartburn

You can make changes to your lifestyle to help relieve your symptoms of heartburn. Here are some things to try:

• Change your eating habits.
  • It’s best to eat several small meals instead of two or three large meals.
  • After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea.
  • Chocolate, mint, and alcohol can make heartburn worse. They relax the valve between the esophagus and the stomach.
  • Spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make heartburn symptoms worse in some people. If your symptoms are worse after you eat a certain food, you may want to stop eating that food to see if your symptoms get better.
• Do not smoke or chew tobacco.
• If you get heartburn at night, raise the head of your bed 6 in (15 cm) to 8 in (20 cm) by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
• Do not wear tight clothing around your middle. Lose weight if you need to. Losing just 5 to 10 pounds can help. For more information, see the topic Weight Management.

Medicines to treat heartburn

Note:

If you are pregnant and have heartburn symptoms, be sure to talk to your doctor before you take any heartburn medicines. Some medicines may not be safe to take while you are pregnant. For more information, see the topic Pregnancy-Related Problems.

Antacids

Many people take nonprescription antacids for mild or occasional heartburn. If you use antacids more than just once in a while, talk with your doctor.

• Antacids such as Tums, Mylanta, or Maalox neutralize some of the stomach acid for 30 minutes to 2 hours, depending on whether the stomach is full or empty. Liquid or dissolving antacids usually work faster than tablet forms.
• Some antacids, such as Gaviscon, have a foaming agent (alginate) that acts as a barrier between stomach acid and the esophagus.
• Antacids such as Pepto-Bismol coat the esophagus and act as a barrier to reflux acid. Pepto-Bismol should not be used for more than 3 weeks and you should not take it if you can't take aspirin. It may make your tongue or stools black. The black color is usually not serious. Brushing your teeth and tongue after taking Pepto-Bismol may keep your tongue from turning black. If your child or teen gets chickenpox or flu, do not treat the symptoms with nonprescription medicines that contain bismuth subsalicylate (such as Pepto-Bismol and Kaopectate). If your child has taken this kind of medicine and he or she has changes in behavior with nausea and vomiting, call your doctor. These symptoms could be an early sign of Reye's syndrome, a rare but serious illness. Ask your doctor if your child younger than 12 should take these medicines.

Antacids work faster than acid reducers (H2 blockers), but their effect does not last more than 1 to 2 hours. H2 blockers can provide relief for up to 12 hours.

Antacids do have side effects. They may cause diarrhea or constipation. Also, antacids can interfere with how your body absorbs other medicines.

If you have any health risks, talk with your doctor before you start taking an antacid. If you have kidney disease, it is especially important to discuss antacid use with your doctor. Regular use of antacids that contain magnesium or aluminum can cause a dangerous buildup of magnesium or aluminum in people who have kidney disease.

Stomach acid reducers

H2 blockers

Acid reducers, also called histamine receptor (or H2) blockers, decrease the amount of acid that the stomach makes, which may reduce irritation to the stomach lining and decrease heartburn. Some examples of nonprescription acid reducers are Pepcid AC, Tagamet HB, Zantac 75, or Axid AR. Talk with your doctor if you take an H2 blocker for more than 2 weeks.

Proton pump inhibitors

Proton pump inhibitors (PPIs), such as omeprazole (for example, Prilosec), reduce stomach acid and effectively treat severe heartburn symptoms. These acid-reducing medicines are used when your heartburn has not gotten better with other home treatment measures, antacids, or H2 blockers. You may need to use a PPI for up to 5 days before you have relief of your heartburn but they are safe to use for long-term management. They also are safe to use if you have kidney or liver problems. PPIs are available without a prescription.

Acid reducers can sometimes change the way other medicines work. If you are taking prescription medicines, be sure to talk with your doctor before you take a nonprescription acid reducer.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Heartburn is not relieved by home treatment and medicine.
• Blood appears in your vomit.
• Blood appears in your stools or you have black, tarry stools.
• You have symptoms of mild heartburn for more than 2 weeks.
• Swallowing problems are not improving.
• You continue to lose weight for no reason.
• Your symptoms become more severe or frequent.

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Author:	Jan Nissl, RN, BS	Last Updated: September 6, 2007
Medical Review:	William H. Blahd, Jr., MD, FACEP - Emergency Medicine William M. Green, MD - Emergency Medicine Martin Gabica, MD - Family Medicine H. Michael O'Connor, MD - Emergency Medicine
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