How Heartburn Is Treated

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Heartburn, also referred to as acid reflux, occurs when stomach acid comes into contact with the lining of the esophagus (feeding tube). This can occur when the lower esophageal sphincter (LES)—the muscle that prevents the backflow of stomach acid into the esophagus—is not working properly.

Most people experience heartburn occasionally, but some have more frequent or serious heartburn symptoms. Depending on the frequency and severity of your symptoms, the treatment options can vary.

Lifestyle changes that minimize heartburn

Verywell / Jessica Olah

This article looks at the various treatments for people with occasional heartburn, including home remedies, lifestyle changes, over-the-counter medications, prescription drugs, and complementary therapies.

Heartburn vs. GERD

Though heartburn is related to gastroesophageal reflux disease (GERD), the terms are not interchangeable. GERD is a more severe, chronic form of acid reflux, while heartburn is essentially a symptom of acid reflux and GERD.

For the purpose of this article, the information will be mainly focused on the treatment of occasional heartburn.

Home Remedies and Lifestyle

You can alleviate heartburn by avoiding food that causes heartburn and making other lifestyle choices that can minimize heartburn symptoms.

Don't Smoke

Nicotine in cigarette smoke relaxes the lower esophageal sphincter. Smoking also stimulates the production of stomach acid. If you suffer from heartburn, stop smoking and avoid secondhand smoke as well.

Lose Weight if Overweight

Being overweight or obese places pressure on the abdomen and increases the risk of heartburn. Heartburn is one of many health reasons why you should aim for a healthy body mass index (BMI) of 30 or lower.

It also helps to loosen the waistband if you have regular heartburn. Anything that compresses the abdomen can directly affect the function of the esophagus. Opt instead for loose-fitting clothes when occasional heartburn strikes.

Avoid Food Triggers

Some common heartburn triggers can be avoided in the following ways:

  • Limit alcohol. Alcohol relaxes the LES muscle. Drinking alcohol can also cause excessive eating which contributes to heartburn.
  • Avoid foods that affect the LES. These include chocolate, peppermint, caffeinated drinks, carbonated beverages, alcohol, fatty foods, and greasy or fried foods.
  • Avoid irritating foods. These include citrus fruits and juices, tomatoes and tomato-based products, chili peppers, and black pepper.

Create a heartburn-friendly diet by keeping a food diary to record which foods are safe for you and which are more likely to trigger heartburn.

Adjust Your Eating Habits

Beyond what you eat and drink, how and when you eat can also trigger heartburn symptoms. To avoid this:

  • Eat smaller, more frequent meals: Eating five or six smaller meals may be easier on the stomach than three larger ones.
  • Don't eat quickly: A handy trick is to put your fork or spoon down between bites.
  • Avoid lying down after eating: Wait at least two to three hours, ensuring your head and chest are elevated above the stomach.
  • Avoid late-night snacking: Again, don't eat within two to three hours of going to bed to avoid nighttime heartburn.
  • Eat foods with antacid properties: These include bananas, chamomile tea, skim milk, fat-free yogurt, and ginger and turmeric tea.
  • Chew gum: Chewing gum or sucking on a lozenge after a meal stimulates the production of saliva which is alkaline and may help counteract stomach acids.
  • Sip herbal tea: Sipping herbal tea can dilute and flush stomach acids from the esophagus. However, avoid caffeinated tea.

Adjust Your Sleep Habits

Nearly 80% of people with heartburn experience heartburn at night. Besides avoiding food before bedtime, there are ways to avoid nocturnal acid reflux:

  • Sleep with your head elevated. Lying flat allows stomach acids to seep through the LES. if you elevate the head with an extra pillow or a special wedge-shaped pillow, this is less likely to occur.
  • Lie on your left side. Doing so reduces the likelihood of reflux by elevating the LES.
  • Wear loose-fitting pajamas. The less pressure you place on the abdomen, the better.

Recap

Certain lifestyle changes can help treat or prevent heartburn. These include quitting cigarettes, maintaining a healthy weight, identifying and avoiding trigger foods, sleeping with your head elevated, and eating smaller, more frequent meals.

Heartburn Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Old Man

Over-the-Counter Therapies

There are several over-the-counter (OTC) remedies for heartburn, some of which were only available by prescription a few years ago.

Antacids

Antacids are commonly used to treat heartburn. They help relieve occasional heartburn and indigestion by neutralizing stomach acids.

Antacids are sold under the following brand names, each of which has slightly different formulations and/or ingredients:

  • Tums: Tums contain calcium carbonate which tends to be stronger and work longer than some antacid ingredients. Calcium carbonate may also increase esophageal motility (movement), limiting the amount of acid that enters the esophagus.
  • Rolaids: Rolaids contain calcium carbonate and magnesium hydroxide. It is available in different strengths (including Extra-Strength and Ultra-Strength) as well as in different forms (such as soft chews and liquid).
  • Mylanta: Mylanta contains aluminum hydroxide and magnesium hydroxide. Mylanta Ultra, available in tablet, chewable, and gelcap forms, contains calcium carbonate.
  • Gaviscon: Gaviscon contains alginic acid and sodium bicarbonate in addition to aluminum hydroxide and magnesium carbonate. The combination creates a gel-like barrier that literally floats on the stomach acid, reducing the amount that enters the LES.
  • Chooz: This is a sugar-free gum with calcium carbonate as the active ingredient.

Antacids can interfere with the absorption of certain drugs, including HIV medications. Speak with your doctor before using antacids to ensure they do not interact with any drugs you are taking.

People who are pregnant should not use antacids containing sodium bicarbonate or magnesium trisilicate as they can cause excessive fluid buildup and affect the development of the fetus.

H2 Blockers

H2 blockers, also known as H2-receptor antagonists, are medicines that reduce the amount of acid in the stomach. They block a chemical called histamine-2 (H2) that stimulates acid-producing cells in the stomach.

H2 blockers are sold under the following brand names:

  • Axid (nizatidine)
  • Pepcid (famotidine)
  • Tagamet (cimetidine)

Side effects are uncommon but may include headache, diarrhea, fatigue, and dizziness.

Proton Pump Inhibitors (PPI)

Proton pump inhibitors (PPIs) also block the production of stomach acid, albeit in a different way. They do so by shutting down a system known as the proton pump that is integral to the production of stomach acid.

Over-the-counter PPIs include:

  • Nexium 24H (esomeprazole)
  • Prilosec OTC (omeprazole)
  • Prevacid 24H (lansoprazole)
  • Zegerid OTC (omeprazole/sodium bicarbonate)

PPIs are generally taken for two weeks and should not be used for an extended period of time.

Side effects include headache, diarrhea, constipation, stomach upset, cough, hoarseness, nausea, and vomiting.

Recap

Over-the-counter medications frequently used to treat heartburn include antacids like Tums and Rolaids, H2 blockers like Tagamet and Pepcid, and proton pump inhibitors (PPIs) like Nexium and Prilosec.

Prescriptions

If OTC medications and lifestyle changes fail to control heartburn, your doctor may recommend prescription versions of H2 blockers and PPIs.

Prescription H2 Blockers

Besides the OTC-strength H2 blockers, there are versions of Axid (nizatidine), Pepcid (famotidine), and Tagamet (cimetidine) available by prescription as well as an H2 blocker called Protonix (pantoprazole).

Prescription H2 blockers are generally more effective than their OTC version but are also more likely to cause side effects. These are intended for the short-term relief of severe heartburn only.

Prescription Proton Pump Inhibitors (PPIs)

Prescription PPIs are available under the following brand names:

Prescription PPIs are meant to be taken under a healthcare provider's supervision and only for a limited time. The chronic use of PPIs is associated with an increased risk of bone fractures, kidney disease, and heart attacks.

Recap

When OTC medications and lifestyle changes fail to provide heartburn relief, there are H2 blockers and PPIs available by prescription that can help. These are intended for short-term relief of severe heartburn symptoms only.

Complementary and Alternative Medicine (CAM)

There are several complementary therapies people use to treat heartburn. The evidence supporting their use is limited, so speak with your doctor to ensure that they are safe and don't interfere with any of the medications you are taking.

Baking Soda

Baking soda, also known as sodium bicarbonate, is a natural antacid. If you dissolve a teaspoon of baking soda into 8 ounces of water and drink it, it may help neutralize stomach acid and temporarily ease heartburn. Side effects include burping and bloating.

Sodium bicarbonate may decrease the effectiveness of aspirin. It should also not be used in people who are pregnant due to the risk of abnormal fluid build-up.

Aloe Vera

Aloe vera juice has been used in traditional medicine to treat esophageal irritation. While it is unwise to use unprocessed aloe vera (as it has potent laxative effects), there are some products that are specially formulated for internal use.

This includes AloeCure, a formulated remedy containing organic processed aloe juice. Marketed as an all-natural remedy for digestive disorders, AloeCure was found to relieve heartburn in several smaller studies.

Aloe vera should be avoided in people on anti-diabetes medications as it can lower blood sugar and cause hypoglycemia. Aloe vera can also interact with blood thinners like Coumadin (warfarin) and Plavix (clopidogrel), increasing the risk of easy bruising and bleeding.

Deglycyrrhizinated Licorice

Deglycyrrhizinated licorice is a natural remedy that is sometimes used to soothe heartburn and other digestive ailments.

On its own, licorice can raise blood pressure and cause undesirable side effects. By contrast, deglycyrrhizinated licorice has the ingredient responsible for this effect (called glycyrrhizic acid) removed.

Some studies suggest that deglycyrrhizinated licorice (including a formulated product called GutGard) is useful in relieving occasional heartburn and indigestion.

Despite having few side effects, deglycyrrhizinated licorice can interact with diuretics, corticosteroids, or other medications that lower the body's potassium level. Taking them together can cause a potentially severe drop in blood potassium known as hypokalemia.

Recap

Complementary therapies used to treat heartburn include baking sodium (sodium bicarbonate), aloe vera, and deglycyrrhizinated licorice. While several smaller studies have suggested they can help, the evidence supporting their use is limited.

Summary

Occasional heartburn (acid reflux) can be often be treated or prevented with lifestyle changes such as quitting cigarettes, maintaining a healthy weight, avoiding food triggers, eating smaller meals, and sleeping on your left side or with your head elevated.

Over-the-counter antacids, H2 blockers, and proton pump inhibitors (PPIs) are also effective in relieving occasional heartburn. People with severe heartburn may require prescription H2 blockers or PPIs to control their symptoms. Medications like these are intended for short-term use only.

Complementary and alternative medicines (CAM) like baking soda, aloe vera, and deglycyrrhizinated licorice have been used to treat occasional heartburn, but the evidence supporting their use is weak.

Frequently Asked Questions

  • How long does heartburn last?

    Heartburn may last anywhere from just a few minutes to several hours. For some, it's an occasional occurrence; for others, it may occur frequently. Make an appointment to see a doctor if you have heartburn more than twice weekly.

  • What is the quickest heartburn remedy?

    Over-the-counter antacids, like Tums, Mylanta, or Rolaids, work by neutralizing stomach acid and are a good option for rapid, short-term relief.

  • What should I take for heartburn during pregnancy?

    Try eating yogurt or drinking milk. Adding a tablespoon of honey into warm milk may also be helpful. Some ingredients in antacids are not recommended during pregnancy, so speak with your doctor before using any over-the-counter heartburn medication.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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