Heartburn medication

introduction

Many people suffer from heartburn at least once in their life. The symptoms often go away on their own within a short time. However, in some people, heartburn is more persistent. To get it under control, various home remedies but also medication can be used.

Drug groups

Various active ingredients can be used against heartburn. So-called antacids can be used for heartburn that only exists temporarily. Prolonged heartburn can be treated with proton pump inhibitors.

Antacids

Antacids are substances that, when ingested, neutralize the acid in the stomach. These are compounds based on magnesium, calcium and aluminum.
Examples of common antacids are aluminum hydroxide, magnesium hydroxide, and calcium carbonate. The therapy of heartburn with antacids is purely symptomatic. This means that only the symptoms of heartburn are treated, not the cause. The stomach acid is neutralized, but the acid production itself is not reduced or stopped. However, antacids are very effective for temporary heartburn.

This article might also interest you: Is aluminum toxic to the human body?

H2 blockers

The H2 blockers block a certain histamine receptor in the stomach, which leads to an increase in gastric acid production. Compared to the proton pump inhibitors (see below) the Inhibition of acid production less pronounced due to the H2 blockers. Preparations belonging to this group are, for example Ranitidine, Famotidine and nizatidine.

Proton pump inhibitors

The protons enter the hydrochloric acid in the stomach via proton pumps in the gastric mucosa. They are therefore an essential part of gastric acid production. With persistent heartburn it therefore helps to block these proton pumps so that not as much acid can be formed in the stomach. This can be achieved by using the Proton pump inhibitors, for example Pantoprazole or Omeprazole.
Also in the therapy of Stomach ulcer Proton pump inhibitors play a major role.

Liquid heartburn medication

Most common heartburn medications are given as tablets. However, some preparations are also available in liquid form and can therefore be easily taken. The available drugs include: Talcid® Liquid (active ingredient: hydrotalcite), Megalac® (active ingredient: Almasilat, contains aluminum), Maaloxan® (active ingredient: Algeldrat, magnesium hydroxide). These liquid medications are usually used for self-therapy for heartburn, can be purchased without a prescription at the pharmacy and can be taken over a period of a few days.

Heartburn medication without aluminum

The active ingredient aluminum is found in some heartburn medications that belong to the group of antacids. These drugs are not recommended because large amounts of aluminum can build up in the bones and brain. Even during pregnancy, you should not take aluminum-containing drugs for heartburn. For example, aluminum is contained in the non-prescription drug Megalac ®.

Heartburn medication for children

Heartburn in children is often caused by an unhealthy diet and should be treated with a healthy lifestyle. Herbal medicines or teas can also be used in children for minor complaints, as these are very well tolerated. If heartburn occurs more frequently, a doctor should look for the cause and possibly treat the symptoms with medication. Children should not take drugs from the group of proton pump inhibitors. The pediatrician can discuss which antacids and H2 blockers are suitable for your child.

Side effects

Side effects can occur when taking the preparations mentioned. With the antacids, complaints in the gastrointestinal area are in the foreground, for example Gas, diarrhea, or constipation such as stomach pain.

Stand by the H2 blockers Headache, dizziness, tiredness and gastrointestinal complaints such as diarrhea or constipation in the foreground.
Proton pump inhibitors can also cause these side effects.

All three drug groups have the potential to interact with other drugs that the patient is taking. It is therefore essential to clarify whether the medication is compatible with the antacid, H2 blocker or the proton pump inhibitor, as otherwise complications can occur.

Herbal medicines for heartburn

If you want to treat mild heartburn with herbal medications, Iberogast®, for example, can help, which uses extracts from nine different medicinal plants to stimulate digestion in the stomach and thus relieve heartburn. Contains: candytuft, angelica root, chamomile, caraway, milk thistle, lemon balm, peppermint, celandine and liquorice root. Of course, teas made from the appropriate herbs also help with mild complaints.
When buying, you should make sure that it does not contain only small amounts of the plants mentioned, as is often the case with teas from the supermarket. Many of the medicinal plants mentioned can also be purchased in drop form in the pharmacy. With peppermint, you should make sure that it is good for your stomach, as it can increase heartburn. Other helpful medicinal plants for heartburn are marshmallow (a tea should be made with cold water), meadowsweet (better to avoid during pregnancy), ginger, lovage, artichoke and mallow.

Home remedies

In addition to medication, there are a number of home remedies that can be used for heartburn. They are particularly suitable for those who have only temporary heartburn. Complaints that persist over a long period of time should be clarified by a doctor.

nutrition

Heartburn is often triggered by a particular diet. Some foods increase gastric acid production and can thereby promote heartburn. These include citrus fruits, coffee, very fatty foods, sweets, and carbonated drinks. People who are prone to heartburn should limit their consumption of these foods. This can often prevent heartburn.
In addition, these foods should especially not be eaten / drunk in the evening, since heartburn can become noticeable, especially when lying down, through the easier reflux of stomach acid into the esophagus.

Read more on the subject at: Diet for heartburn

Baking soda

Soda is similar to baking powder. It can be dissolved in water and drunk, and it causes heartburn Neutralization of gastric acid. However, it is not suitable for long-term heartburn therapy.

Starchy foods

Eating starchy foods such as dry potatoes, rusks and dry white bread is also effective in neutralizing excess stomach acid.

Healing earth

Healing clay is very effective in treating heartburn. It can be mixed or taken in capsule form and very effectively binds excess stomach acid and other harmful substances from the gastrointestinal tract. Healing earth is very well tolerated and therefore recommended for temporary heartburn.

Read more about the topic here: Healing earth

tea

Different types of tea have a calming effect on the gastrointestinal tract and can therefore be used as supportive treatment for heartburn. These include, for example Camomiles-, fennel- and Caraway Tea. Tea mixtures made from stomach-friendly herbs can also be drunk.

Upper body elevation

Heartburn can be particularly bad when lying down. This is because, in a horizontal position, stomach acid can more easily flow back towards the esophagus. In an upright position, gravity helps hold the acid back in the stomach.
People with heartburn can often improve their symptoms by sleeping with their upper bodies slightly elevated. Just put a couple of pillows under your torso.

Worsening heartburn

Alcohol and smoking lead to a increased production of stomach acid. Therefore, they can significantly increase the symptoms of heartburn. In addition, they promote relaxation of the stomach sphincter so that stomach acid can flow back into the esophagus even more easily. Therefore, people who suffer from heartburn should absolutely refrain from alcohol and smoking.

Spicy food irritates the stomach walls. The result is an increase in acid production and consequently the development or worsening of heartburn. Instead, those affected should choose mild foods that tend to bind the acid in the stomach and not encourage increased acid production.

Heartburn during pregnancy

From Heartburn during pregnancy Unfortunately, many women are affected. This is due to the fact that the growing child takes up more and more space in the mother's abdomen over time and thus also puts pressure on the stomach. The stomach acid is pushed up more easily and can pass into the esophagus.
In addition, certain hormones relax the muscles at the stomach entrance. This also makes it easier for acid to pass into the esophagus.

To the End of pregnancy heartburn becomes one according to the height of the child more common problem. Pregnant women can relieve the discomfort by applying the above Home remedies try to alleviate. If this does not bring the desired relief, it can also be used during pregnancy Medication be taken for heartburn.

Mild discomfort can be temporary with one Antacid or one H2 blockers be treated, which neutralize the stomach acid as described, or reduce its production.

Persistent and severe discomfort can also occur with one Proton pump inhibitors be treated. The preparation is used during pregnancy Omeprazole prefers. However, all non-drug treatment measures should be tried before using any medication. It is always better to avoid medication during pregnancy if the woman's state of health allows it.

Many women also take it homeopathic remedies for heartburn or acupressure, respectively acupuncture. In some women, these alternative procedures can also help to relieve the symptoms.

An easily digestible, balanced and healthy diet is particularly important in order to prevent heartburn during pregnancy. If you follow general nutritional and everyday tips (reducing stress, drinking enough water, taking small meals), heartburn occurs much less frequently during pregnancy.

What drugs are allowed in pregnancy for heartburn?

Not all medications should be taken during pregnancy because these can enter the child's bloodstream via the mother's blood and placenta and are or can be harmful to the child. Drugs from the group of proton pump inhibitors, or PPIs for short, are not permitted during pregnancy and breastfeeding.
Antacid drugs are safe if they do not contain aluminum. Preparations containing calcium carbonate and / or magnesium carbonate are advisable.
Drugs from the group of H2 blockers and their effects on the unborn child have been adequately investigated; there is no negative impact on the child. Nevertheless, H2 blockers should only be used during pregnancy if antacids cannot improve the symptoms sufficiently . Ranitidine should preferably be used because this is where most of the experience regarding use in pregnancy is available. Of course, herbal medicines for heartburn can also be used during pregnancy: chamomile, liquorice root, angelica or candytuft are e.g. Recommended as teas.

Read more on the subject at: Heartburn during pregnancy

Esophagitis

The backflow of stomach acid into the esophagus can cause a Esophagitis, called esophagitis. This is often expressed through Pain at the level of the sternum and difficulties swallowing.

At a Gastroscopy The esophagitis can be viewed medically using an endoscope. It can be present in different degrees of severity and have different causes. Is it caused by the refluxing stomach acid. This must therefore be treated in order to also relieve the esophagitis.
They are used as with normal heartburn without esophagitis, depending on the severity Antacids or Proton pump inhibitors.

Since heartburn has often been present for a long period of time in the run-up to inflammation of the esophagus, proton pump inhibitors are often the drug of choice because they are more effective and can be used over the long term.In addition, the patient should also be informed about general behavioral measures that are indicated for their complaints. This includes the right one nutrition in rather small portions, if possible avoiding coffee, alcohol and nicotine, elevation of the upper body for heartburn, sufficient amounts of water to drink, etc. Under these circumstances, esophagitis can usually be treated well and the patient will quickly feel the first improvements.

Drugs for heartburn and esophagitis

Heartburn is caused by the backflow of acidic stomach contents into the esophagus. This can lead to an inflammation of the esophagus called reflux esophagitis. If you have heartburn every now and then, medication isn't really necessary. It is a physiological reflux, which e.g. can occur after a very fatty meal or after drinking wine. Medication should be given if symptoms occur more frequently or if the esophagus is inflamed.
1) PPI: The most frequently used drugs end with "-prazole" (e.g. omeprazole, pantoprazole) and belong to the group of proton pump inhibitors, or PPIs for short. They block a transport protein in the stomach cells, which inhibits the production of stomach acid. With sufficient dosage, healing rates of around 90% are achieved. Slightly more common side effects include diarrhea, dizziness, and headache. Mood swings are also possible. Less common side effects are visual and hearing impairments, an increase in liver values, inflammation of the kidneys and a rash. Long-term therapy with PPIs can lead to a vitamin B12 deficiency if it is not replaced.
2) H2 blockers: These drugs end in "-tidine" (e.g. cimetidine) and are not used to treat heartburn or esophagitis. They are much weaker than the PPI.
3) Antacids: These drugs are weak and have a short-term effect. They neutralize the stomach acid that is present. They are only recommended for occasional heartburn without esophagitis.

Are you interested in this topic? You can read more about this in the following article: Omep®

Over-the-counter heartburn medications

Many heartburn medications are available over the counter from pharmacies. These include preparations from the group of antacids and H2 blockers. The Proton pump inhibitors require a prescription in higher doses. In lower dosages up to 20mg however, they are also available in pharmacies without a prescription.

In the case of persistent and / or severe complaints, should Heartburn medication however, only be taken after consultation with a doctor. He can first clarify the complaints and individually select the appropriate therapy for the respective patient.

Prescription drugs

Antacids usually do not require a prescription and are available over the counter in pharmacies. The H2 blockers famotidine and ranitidine are also available over the counter in low doses; higher doses, like the higher dosed proton pump inhibitors, must be prescribed by a doctor.

What to do if the heartburn does not go away despite medication?

If the heartburn does not go away despite taking medication, there may be various causes. In many cases, heartburn persists because the patient has a lifestyle that encourages heartburn to develop. Important pieces of advice are: reduce excess weight, eat small and low-fat meals, do not eat dinner late at night and do not lie down immediately after eating. Sleeping with your torso elevated and on your right side can help with heartburn. Furthermore, foods that trigger heartburn particularly frequently should be avoided. These include: chocolate, wine and other alcoholic beverages, sour fruit juices, coffee, sparkling water, tomato sauce and garlic.
It is also useful for a doctor to check whether a patient is taking other medications that favor heartburn (e.g. anticholinergics for prostate problems, calcium channel blockers for high blood pressure, etc.). If severe heartburn persists despite taking medication, the doctor must also seek out other physical causes for the failure. The patient may suffer from delayed gastric emptying, the drugs then stay longer in the stomach and are inactivated. A gastroscopy is performed for diagnosis. When Zollinger-Ellison syndrome exists, the production of stomach acid is increased due to increased levels of the hormone gastrin. Determining the gastrin concentration after discontinuation of the proton inhibitors can rule out Zollinger-Ellison syndrome.
Another reason for heartburn to persist may be if you are taking NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen or diclofenac.