Occasional heartburn is common. But heartburn that interferes with your daily activities (like sleeping, exercising, working, and so on) should be evaluated by a physician. In some cases, a physician will require the patient to undergo testing, but most physicians will initially prescribe some form of acid-repressive therapy. If the patient does not respond to treatment, then it is more likely that testing will be required to make a diagnosis.
Making Lifestyle Changes
The most effective, and sometimes most difficult, way to improve your heartburn symptoms is to make lifestyle changes. Start with your diet—eat more fiber, consume less fat and sugar, and eliminate processed foods, caffeine, and alcohol.
Keep a handle on your stress levels. The National Heartburn Alliance says 58 percent of frequent heartburn sufferers identify “hectic lifestyle” as a factor that contributes to their heartburn. While stress is a normal part of life, stress can lead to behaviors that may trigger heartburn—smoking, increased alcohol consumption, and so on.
Some natural supplements may be useful in managing acid indigestion. Supplements that are thought to aid in reducing heartburn include the amino acid L-glutamine, vitamins C and E, and aloe vera. Some health care providers recommend taking a licorice extract known as DGL. Chewing DGL tablets may create a protective coating for the esophagus and stomach. Always talk to your health care provider about any supplements you are taking.
For heartburn, you have several different over-the-counter and prescription medications that may provide relief. Your best option is always to make the lifestyle changes that eliminate the heartburn in the first place.
Antacids neutralize excess stomach acid. Even though stomach acid can still splash into the esophagus, it gets neutralized. Antacids provide fast relief of symptoms, but relief is short-lived, and usually lasts about half an hour.
Over-the-counter medications are still medicines, even if they do not require a prescription. Follow the recommendations on the label and talk to your heath care provider about how often you are taking them, because antacids, for example, can interfere with other medications.
Sodium bicarbonate is a simple treatment for episodic (or occasional) heartburn. Drink a solution of a small amount of baking soda mixed with water. The baking soda neutralizes the acid that causes the pain. Don’t do this often, as excess sodium intake may raise blood pressure and cause other health problems.
H2 blockers are sometimes referred to as acid reducers or H2 receptor antagonists. They can be found in both prescription and nonprescription strength. Obviously, the prescription-strength formula is stronger than what you can purchase over the counter. They work by decreasing the amount of acid the body releases into the stomach.
Acid reducers are known as systemic, which means they have to be absorbed into the bloodstream to work. The drawback of H2s is that they can take 30 minutes or longer before they start working. Because they don’t offer fast relief of symptoms, H2s are better used to prevent heartburn. For example, if you are eating a late meal or something particularly rich that you suspect may causes problems, then taking an H2 may prove beneficial. Tagamet, Pepcid, and Zantac are all examples of H2s.
Alginates are another medication option and work faster than H2 blockers. Made from brown seaweed, alginates work by forming a protective barrier in the stomach. That barrier prevents stomach acid from refluxing back up into the esophagus. Because it is nonsystemic, it doesn’t need to be absorbed into the bloodstream. Alginates provide heartburn relief for about four hours, which is longer than antacids. Because antacids work quickly, some brands of alginates offer both antacids and alginates in a single medication. An example of an alginate is Gaviscon.
When is heartburn not just heartburn?
The pain caused by heartburn and heart pain (whether an actual heart attack or recurrent heart pain, called angina) can be so severe that both patients and doctors may have a difficult time distinguishing one from the other. Since there are all degrees of heart pain, your doctor may order additional tests to differentiate between the two diagnoses.
The most commonly prescribed medications for heartburn and GERD are the proton pump inhibitors, called PPIs. These are a class of medications that may work for people who do not respond to antacid or acid blockers. Brand names include Prilosec, Nexium, Aciphex, and Protonix, and, despite advertising to the contrary, they are all similar. Proton-pump inhibitors work directly to block acid production in the stomach cells. PPIs are systemic and work by deliberately disabling the system that controls the pH (acidity) of the stomach. Proton-pump inhibitors offer long-lasting relief, but do not work quickly.
Heart symptoms include a feeling of fullness, tightness, or dull pressure or pain generally in the center of the chest. Pain may spread to the shoulders, neck, or arms and may be accompanied by a cold sweat; you might experience lightheadedness, weakness or dizziness, shortness of breath, and nausea and possible vomiting.
Nixing Nighttime Problems
An easier method of raising your bed may be to use an eight- to ten-inch foam wedge underneath your mattress. Place a towel under your bottom and lower back to prevent you from sliding. Don’t prop up your head with pillows—this crunches your stomach and may worsen reflux.
Aside from all of the stomach pain and problems caused by GERD, many people also suffer from insomnia or lack of sleep because symptoms interfere with their nighttime rest. A survey of 500 adults conducted for AstraZeneca found that 91 percent had GERD symptoms that disrupted their sleep, and for 44 percent it happened at least once each week.
Raising the head of the bed uses gravity to keep stomach acid down where it belongs, in the stomach. Try raising the head of your bed four to eight inches by placing blocks or bricks under the legs. If your bed is on casters, try attaching jar lids to the blocks to cup the wheels and prevent your bed from rolling off the blocks in the middle of the night.