Heartburn medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Treatment
Prevention
If heartburn occurs when lying down, elevating the head of the bed, or elevating the upper body with pillows or sleeping sitting up frequently provides relief. Avoid pillows that raise the head only, as this does little for heartburn and places continuous strain on the neck. To minimize attacks, a sufferer may find benefit in avoidance of certain foods that relax the opening between the stomach and esophagus, such as chocolate, peppermint, and chamomile tea shortly before bedtime.
Medications
Antacids, H2-receptor antagonists, alginates and proton pump inhibitors are used (in that order) to treat heartburn.
Antacids
Antacids work by neutralizing excess stomach acid. So although stomach acid will still splash up into the esophagus (acid reflux) the stomach acid will be neutralized and therefore will lead to lesser or no heartburn symptoms (the burning feeling). Antacids provide fast relief of symptoms, but relief typically last for just 30-60 minutes.
Sodium bicarbonate
A simple and relatively harmless way to treat a one-off heartburn is to drink a solution of a small amount of Sodium bicarbonate mixed with water, which quickly neutralizes the acid that causes the pain. Excess sodium intake does, however, raise blood pressure and cause other undesirable health effects if resorted to with any frequency.
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.
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 90-95% of patients of heartburn or esophageal disorder can link their symptoms to specific foods. Therefore, it is important that heartburn patients manage their diets as a way to treat their heartburn. Patients 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.
Bananas
Are a natural antacid so eat one for instant relief of heartburn. The inside of the banana skin is also good for soothing mosquito bites.