Heartburn (Acid Reflux) Treatments

Medications

Antacids, H2-receptor antagonists, alginates, proton pump inhibitors, and other alternative treatments are used to treat heartburn.

Examples of antacids include:

Alka-Seltzer
Quick-Eze
Tums, Alka-2, Titralac, Surpass Gum
Milk of Magnesia
Amphojel, Alternagel
Maalox, Mylanta, Rolaids, Gelusil, Gaviscon
Pepto-Bismol

Antacids

Antacids work by using bases to ease pain. Although stomach acid will still splash into the esophagus, it will be neutralized, leading to decreased or absent heartburn symptoms. Antacids provide fast relief of symptoms, but relief typically lasts only for a short time.

Sodium bicarbonate

Sodium bicarbonate is a base; when introduced to the stomach, this compound acts as an antacid. A simple and relatively harmless way to treat a one-off heartburn is to drink a solution of a small amount of sodium bicarbonate (baking soda) mixed with water, which quickly neutralizes the acid that causes the pain. Excess sodium intake, however, is thought to raise blood pressure and cause other health problems.

H2-receptor antagonists

Often called H2 blockers, H2-receptor antagonists work by decreasing the amount of acid the body releases into the stomach. H2s are systemic, meaning they require absorption into the bloodstream in order to work. Therefore, H2s can often take 30 minutes or longer before they start working, and therefore are often taken to prevent heartburn rather than for fast relief of symptoms.

Alginates

Alginates work differently than antacids and H2 blockers, by forming a protective barrier in the stomach that prevents stomach acid from refluxing back up into the esophagus. Alginic acid is naturally derived (from brown seaweed) and is non-systemic. Alginates provide faster relief than H2-receptor antagonists and PPIs, and longer-lasting relief than antacids. This is also known to have a better overall outcome for relief.

Proton-pump inhibitors

Proton pump inhibitors, called PPIs, are a class of medications which can be effective for people who do not respond to antacid or acid blockers. Proton-pump inhibitors are systemic and directly block acid production in the stomach cells. In order to prevent heartburn the medication disfigures and disables the proteins (proton pumps) that control the pH of the stomach, allowing the body to digest them. Proton-pump inhibitors are not fast-acting, but provide long-lasting relief. PPIs are intended to be short-term medications only.

Restricting diet

Restricting diet is very important, since approximately 90-95% of sufferers of heartburn or esophageal disorder can link their symptoms to specific foods. Therefore, it is important that heartburn sufferers manage their diets as a way to treat their heartburn. Sufferers should choose the kinds of foods and drinks which have little risk of causing acid reflux, while some kinds of foods or drinks should be avoided as they are major heartburn triggers. Specifically, it has been shown that fatty foods and caffeinated beverages can cause the symptoms of heartburn.

Drinking milk is not a recommended treatment to heartburn. A glass of milk can provide quick relief; however, milk contains calcium and protein, which both stimulate more acid production in the stomach. Consequently, shortly after drinking a glass of milk, a harsher heartburn can return.

Positional therapy

Sleeping on the left side has been shown to reduce nighttime reflux episodes in patients.

A meta-analysis suggested that elevating the head of bed is an effective therapy, although this conclusion was only supported by nonrandomized studies. The head of the bed can be elevated by plastic or wooden bed risers that support bed posts or legs, a therapeutic bed wedge pillow, or a wedge or an inflatable mattress lifter that fits in between mattress and box spring. The height of the elevation is critical and must be at least to be at least minimally effective to prevent the backflow of gastric fluids. Some innerspring mattresses do not work well when inclined and may cause back pain; some prefer foam mattresses. Some practitioners use higher degrees of incline than provided by the commonly suggested and claim greater success.

Surgery

In some cases, laparoscopic surgery of the esophagus may be a possible alternative treatment.