Acid Reflux: How To Know When You Need More Than Medicine

January 21, 2020

Do you take over-the-counter medicine for heartburn? If you’re taking antacids or H2 blockers more than once a week to ease your pain, there may be a better, long-term solution for your symptoms.

Heartburn, or acid indigestion, is a symptom of acid reflux. Acid reflux occurs when stomach acid backs up into the esophagus, irritating the tissues. Heartburn gets its name from where you feel the burning sensation caused by the stomach acid – just behind the heart, where the esophagus lies.

Gastroesophageal reflux disease (GERD) is a chronic, more severe form of acid reflux. This serious condition can also lead to precancerous changes in the lining of the esophagus.

OTC Medicines for Heartburn

If your heartburn is infrequent or moderate, over-the-counter medicines, which include antacids such as Tums and Alka-Seltzer, H2 blockers such as Zantac and Pepcid, or proton pump inhibitors such as Prevacid and Nexium, are effective, says gastroenterologist John Dumot, DO, Director of the Digestive Health Institute at University Hospitals.

Antacids work by neutralizing the acid in your stomach, while H2 blockers and proton pump inhibitors work by suppressing stomach acid production.

“Over-the-counter medicines can work quickly and are safe for intermittent problems, along with lifestyle changes such as eating smaller meals, avoiding late-night eating or lying down after eating,” Dr. Dumot says.

The Role of Stomach Acid

But over-the-counter medicines that get rid of stomach acid are not a long-term solution to constant heartburn, Dr. Dumot says.

You may be making the symptoms go away with medicine, but not addressing an underlying problem.

“Gastric acid is part of our natural makeup -- just not in the esophagus,” he says. “The acid helps you to digest the food and protects you against infection. When you suppress acid, you can be affecting your health by affecting the digestive process.”

When Is It Time to Talk to Your Doctor?

If you experience heartburn or regurgitation more than once a week, it’s time to talk with your doctor, Dr. Dumot says.

“People should be evaluated if they have chronic acid reflux to make sure their medical treatments are adequate, safe and correct and to determine if they have had damage to the esophagus,” Dr. Dumot says.

If medications don’t provide relief, further treatment options might include procedures intended to repair or replace the valve that connects the stomach and esophagus, which is often the culprit for acid reflux.

They include:

Laparoscopic fundoplication
Transoral incisionless fundoplication
LINX® Reflux Management System

Try to Lose Weight

One way that people who have acid reflux can help themselves is by losing weight, Dr. Dumot says.

Obesity is one of the major drivers of acid reflux because excess abdominal fat causes several structural and functional changes around the valve that closes off the esophagus from the stomach.

“Weight loss is really the most effective way to lose acid reflux,” he says.