Natural Solutions for Acid Reflux
Get Relief for Your Heartburn
Heartburn relief is sometimes a question of matching medication to the causes of your heartburn. But you may also find relief simply by making the right diet and lifestyle changes.
By Beth W. Orenstein
Medically Reviewed by Lindsey Marcellin, MD, MPH
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When you have occasional heartburn — that burning feeling in your chest and a sour, acidic taste in your mouth — all you want is to feel better. Fortunately, you can find heartburn relief in a variety of ways, including taking over-the-counter (OTC) antacids and making a few simple changes. To get relief, you need to match heartburn medications to the severity and frequency of your symptoms.
"I usually recommend antacids when people have intermittent or occasional heartburn," says Michael Rahmin, MD, a gastroenterologist at The Valley Hospital in Ridgewood, N.J. "Antacids are good for mild cases of heartburn."
Antacids — familiar products such as calcium carbonate tablets (Tums), calcium carbonate and magnesium hydroxide tablets (Rolaids), and aluminum hydroxide and magnesium hydroxide liquids (Mylanta and Maalox) — work by neutralizing acid in your stomach. However, these products don't block acid secretion, which is one of the causes of heartburn.
Antacids are effective, but on a limited basis, says Ralph J. Katsman, MD, a gastroenterologist with Digestive Health Services in Tacoma, Wash. "If you eat something that's too fatty or too spicy, they're pretty good at cutting down acid for a short period of time and offering some relief," he says. "But antacids are not a good long-term option. There are much better medications on the market for that."
Also, antacids can cause side effects including diarrhea and constipation. And if you have kidney disease, never use antacids containing calcium carbonate or aluminum and magnesium ingredients without first talking to your doctor.
Other medications to counter the causes of heartburn include:
- Foaming agents.Available OTC, these medications, such as Gaviscon, work by coating the stomach.
- H2 blockers.Available over-the-counter or in prescription strength from your doctor, H2 blockers provide short-term symptom relief by decreasing acid production, rather than simply neutralizing acid that has already been produced. H2 blockers, such as Zantac and Pepcid, can give up to 12 hours of relief, Dr. Katsman says.
- Proton pump inhibitors (PPIs).PPIs such as omeprazole (Prilosec, Zegerid) are great for frequent heartburn, defined by symptoms that occur more than one day per week. Like H2 blockers, PPIs are available in prescription and OTC strength. PPIs work by deactivating the acid-producing pumps in the stomach, offering 24-hour relief with one dose a day.
- Prokinetics.These prescription-only drugs strengthen the lower esophageal sphincter (LES) and speed stomach emptying. However, Katsman says, they have a long list of possible side effects, some of which are significant and include fatigue, sleepiness, depression, anxiety, and problems with physical movement. Also, prokinetics tend to lose their effectiveness over the long term. "We don't use this type of medication very often," Katsman says.
Heartburn Relief Through Lifestyle Changes
Lifestyle adjustments also can help provide heartburn relief. In fact, they can be as important as medication in treating your symptoms, Katsman says. Try these strategies:
- Watch your diet.Some foods and beverages are likely to irritate the lining of your esophagus. Others seem to weaken the LES and make it more likely that reflux will occur. Common heartburn- causing foods include fried or fatty foods, chocolate, peppermint, alcohol, caffeinated or decaf coffee, carbonated beverages, garlic, onions, ketchup, mustard, and acidic foods such as vinegar, tomatoes and tomato sauce, and citrus fruits and juices. "Most patients know which particular foods cause their heartburn," Dr. Rahmin says.
- Watch when you eat.Eat at least two or three hours before going to bed or lying down. When you do lie down, it may help to elevate the head of your bed 4 to 6 inches using blocks or telephone books so that it's harder for your stomach acid to regurgitate.
- Watch how much you eat.Overeating puts pressure on your stomach. Also, it can cause weight gain, and being overweight is among the top heartburn causes, Katsman says. If you are overweight, try to slim down by eating a low-fat, high-fiber diet and exercising for at least 30 minutes five times a week.
- Wear loose-fitting clothing.It's especially important to avoid tight-fitting clothing around the waist and lower abdomen to avoid putting pressure on your gastrointestinal tract. Control-top panty hose and body shapers are no-nos. Doing sit-ups, leg lifts, and abdominal crunches also may put pressure on your waist.
- Quit smoking.Studies show that smoking may affect the LES muscle and keep it from working properly. "While the evidence on nicotine and its effect on the LES is not really strong, with all the other medical problems smoking can cause, it would be beneficial to quit," says Katsman.
If you have heartburn on occasion, you may find relief with OTC antacids and other medications, but aim for making lifestyle changes as much as you can. If your symptoms persist or your heartburn is severe, consult with your doctor. He or she can help you find the best solution for your heartburn and be sure that no other condition is behind your discomfort.
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