US experts explain how to choose an over-the-counter remedy for heartburn
In the United States, gastroenterologists explained that the choice of an over-the-counter remedy for heartburn depends on the frequency and nature of symptoms. As Channel NewsAsia reports, antacids, H2-receptor blockers, proton pump inhibitors and alginate-containing medications work differently and may relieve burning, pain or regurgitation.
Heartburn occurs when the valve between the stomach and the esophagus weakens, allowing acid from the stomach to enter the esophagus. Byron Cryer, president of the American Gastroenterological Association, noted that symptoms can be triggered by large food portions, red wine, tomato sauce, chocolate, and mint candies or chewing gum. The risk is also higher during pregnancy, with excess weight, and in people taking GLP-1 medications that slow stomach emptying.
Which medications are used
Antacids neutralize acid in the stomach almost immediately, so they are used for rapid relief of mild and infrequent symptoms. However, they do not reduce acid production.
H2-receptor blockers prevent acid production and may be useful for more intense burning or pain occurring once or twice a week. They can be taken daily for prevention or after symptoms appear; their effect may begin within an hour.
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Proton pump inhibitors block an enzyme in stomach cells that secrete acid. According to Craig Reed, a gastroenterologist at UNC Health in North Carolina, such medications may be most useful for people with chronic heartburn. They are best taken on an empty stomach.
Alginates, compounds derived from seaweed, form a gel-like barrier between the stomach and the esophagus. They may be recommended for people with regurgitation, when stomach contents return to the throat; these remedies can be combined with other classes of medications.
When to see a doctor
Experts advise consulting a gastroenterologist if over-the-counter medications have to be taken for more than 10 consecutive days or if heartburn occurs more than a few days a week. Heartburn accompanied by difficulty swallowing or unintended weight loss is also a reason to see a doctor: such symptoms may indicate gastroesophageal reflux disease or inflammation of the esophagus.
Long-term use of proton pump inhibitors, according to Byron Cryer, may increase the risk of vitamin B12 deficiency, osteoporosis, or a severe intestinal infection caused by C. diff bacteria. To prevent heartburn, doctors advise avoiding individual dietary triggers, not lying down immediately after eating, elevating the head during sleep, and reducing alcohol consumption and smoking. According to experts, evidence for the effectiveness of chamomile tea, ginger, or licorice extract against heartburn is insufficient.
