Nearly all of us have had the familiar but unpleasant pain of heartburn after a meal. When extra stomach acid backs up into your esophagus through the lower esophageal sphincter (a condition known as acid reflux), the discomfort can be intense. If this happens to you only on rare occasions, it may be due to something you ate. For some of us, though, the grinding pain of acid reflux is an everyday occurrence. If you find yourself in that unlucky group, what kinds of drugs are safe and effective enough to find lasting relief?

What Helps Acid Reflux Go Away?

Part of knowing which drug is right for you hinges on understanding what is causing your heartburn. Indigestion and acid reflux can be caused by food that disagreed with you, lifestyle factors and stress, or larger gastrointestinal issues such as gastroesophageal reflux disease (or GERD). 

Depending on the cause and severity of your symptoms, several different medications may bring relief. For most people, diet and lifestyle changes, such as not eating late at night and avoiding certain foods, can also help reduce the symptoms of acid reflux.

What is the Best Medicine for Acid Reflux?

Finding the best drug to help fight acid reflux depends on when you need relief. If you are looking for immediate relief from the symptoms of sudden heartburn, taking over-the-counter antacids like Tums or Alka-Seltzer may be your best bet. For bouts of recurring acid reflux that happen a few days a week, H2 blockers like Pepcid AC can be the answer, though it is not recommended that you take these drugs for more than a couple weeks. 

To solve longer episodes of recurring heartburn, proton pump inhibitors (PPIs) are usually recommended. This last class of drugs, including brand names such as Nexium and Prilosec, is typically the most effective for frequent, ongoing heartburn. As with H2 blockers, though, there is a limit to how long you should regularly take PPIs. 

To decide which of these three classes of drugs will be the best fit for you, it helps to know more about how they work and when they should be taken to provide the best results. Since many of the most effective drugs are prescription medications, consulting with your healthcare provider is a must if you are trying to solve long-term heartburn. Even though lifestyle and dietary factors can contribute to your ongoing condition, you may be referred to a gastroenterologist if your doctor thinks there could be deeper, underlying issues causing your indigestion. 

Drugs for Immediate Heartburn Relief

If acid reflux strikes suddenly, your greatest concern is likely to be getting fast relief. For these situations, over-the-counter (OTC) antacids are going to be the drug of choice. Though these medications do not provide long-lasting freedom from the symptoms of acid reflux or GERD, they can bring quick relief by neutralizing acid when symptoms strike suddenly. 

Common antacids typically use aluminum hydroxide gel, magnesium hydroxide, or calcium carbonate to help reduce the amount of acid in your stomach. Brand names for these products include the following:

  • Alka-Seltzer
  • Gelusil
  • Maalox
  • Mylanta
  • Pepto-Bismol
  • Rolaids
  • Tums

Like all medications, antacids do have potential side-effects. These include diarrhea and constipation, and are more likely if you are taking antacids more frequently or for a longer period of time than is recommended. Another potential issue with prolonged antacid use is that extra calcium can build up in the body, which can lead to the formation of kidney stones. As tempting as it may be to try to control persistent heartburn with OTC antacids, if your symptoms continue for more than a couple of weeks, you will need to find more effective drugs. 

Drugs for Short-Term Relief from Heartburn

If you experience frequent heartburn, moving from antacids to H2 blockers can help you by heading off a bout of acid reflux before it starts. H2 blockers work by preventing your histamine levels from stimulating stomach acid production. These medications use active ingredients such as famotidine or cimetidine, and typically take an hour or more to become effective. H2 blockers have the benefit of lasting for as much as 8-12 hours after you take them. 

The side effects of H2 blockers are usually mild, but the list is longer than what you find for antacids. Side-effects can include:

  • diarrhea
  • constipation
  • fatigue
  • drowsiness
  • headache
  • muscle aches
  • abdominal pain

One of the drawbacks of H2 blockers is they are not designed for long-term use. Over time, your stomach can adjust to the presence of these medications, making them less effective for you over time. In some cases, your doctor may recommend taking H2 blockers for up to six weeks, but you should only take these drugs for this long if you have been specifically told to by your doctor. 

Drugs for Long-Term Heartburn Relief

If you frequently experience acid reflux, or have been diagnosed with GERD, taking H2 blockers will not likely provide the long-term relief you need from symptoms of heartburn. Proton pump inhibitors such as Prilosec (omeprazole), Protonix (pantoprazole), and Prevacid (lansoprazole) are usually the last line of defense in acid reducers. These prescription medications can be taken for longer periods than H2 blockers, though they still have potentially negative effects on your health if taken for too long. 

This category contains one of the more prominent drugs to be pulled from the market in recent years. Zantac, which had previously been widely prescribed, was found to be a potential carcinogen. Though the Food and Drug Administration has pulled this drug from the market, long-term use of other PPIs can still have a wide range of potential negative effects. Studies have linked the use of PPIs to diseases and conditions including increased risk of dementia, vitamin deficiencies, higher risk of C. difficile infections, risk of bone fractures, and more. 

Aside from potentially serious consequences of long-term use of PPIs, proton pump inhibitors can also cause side effects similar to those resulting from H2 blockers. Nausea, flatulence, abdominal pain, and headaches are all listed as potential side effects. 

Talk to Your Doctor About Acid Reducing Drugs

The bottom line in picking medicine for persistent heartburn is that no class of drugs should be taken regularly for long periods of time. If your heartburn has persisted past a couple of weeks, and if it is more frequent than two days a week, you should consult with your doctor to get a better idea of what might be going on and what you can do to treat it. 

It is especially important to talk to your healthcare provider if you were taking Zantac. This ranitidine-based drug has been pulled from the market by the FDA over the presence of potential cancer-causing agents. If you had been relying on Zantac and now need to search for a new drug to help control your heartburn, seeking medical advice from a qualified gastroenterologist is strongly recommended.

Though it could be tempting to keep taking antacids or other over-the-counter drugs just to manage your symptoms, this is not a good long-term strategy. GERD and other conditions like it can be the result of serious issues in your gastrointestinal tract, and finding the right diagnosis can be crucial. Not only could identifying proper diagnosis and treatment bring lasting relief, but it might save you from more serious issues such as cancer. 

If you have been managing the symptoms of acid reflux without finding lasting relief, it is time to talk to your doctor. At Cary Gastroenterology, we can help you find the cause of your discomfort and work with you to navigate the various treatment options that may be available. Request an appointment today if you are ready to start looking for a lasting solution to your heartburn.