Tums and pepto bismol

Everything You Need to Know About Easing Heartburn

You’ve stopped eating before bedtime. You’ve switched to smaller meals. You’ve black-listed trigger foods from your diet. But despite your best efforts to avoid heartburn, sometimes acid indigestion just happens. And then all you want is fast heartburn relief.

“The stomach produces acid normally — it’s supposed to, to help digest food for absorption,” says Matthew J. Wyneski, MD, associated staff member in pediatric gastroenterology at the Cleveland Clinic in Ohio. “If the stomach makes too much acid, if the stomach is too full, or if the junction between the esophagus and stomach is weak, that acid can go from the stomach back into the esophagus, causing an irritation in the esophagus.” The acid causes a burning, and even sour, sensation in the esophagus, which equals burning in the chest, which equals heartburn.

Here’s what you can do to ease heartburn.

If You Go Over-the-Counter (OTC)

For fast heartburn relief, many people turn to chewable antacids with calcium such as Tums or Rolaids. They work by neutralizing stomach acid and are useful for occasional, mild heartburn. Symptoms can lessen within minutes.

Mylanta and Pepto-Bismol offer liquid relief for occasional and non-severe heartburn symptoms. Like Tums and Rolaids, they can quickly provide heartburn relief and act as a buffer. Unlike the other medications, these provide a protective barrier to help block acid irritation.

Another type of OTC heartburn relief is a histamine blocker. “Pepcid, Zantac, and Tagamet act within the body to tell the acid-producing cells of the stomach to produce less acid,” says Dr. Wyneski. “These may work within 20 to 30 minutes and can be used for mild to moderate issues that are more frequent.”

Finally there are proton pump inhibitors (PPIs) such as Prilosec and Prevacid, which tend to be used when people have chronic and recurring issues. These often have the most drastic effect on decreasing the amount of stomach acid, because they go into the acid-producing cells of the stomach and almost completely turn off the acid production. However, relief tends to take longer, two to three days and sometimes even weeks.

If You Go Natural

“There are many natural remedies people use to help take the burn out of heartburn — chamomile, aloe vera juice, slippery elm,” says Dr. Tipton. Still, “avoiding foods that are acidic and contain caffeine may be the most natural way to avoid heartburn.” If you decide to try an herbal remedy, clear it with your doctor to make sure it won’t adversely interact with any other medications you take.

Sometimes it’s all about finding the right position. A review published in the Archives of Internal Medicine, found that people who sleep with their heads elevated (the study used 28-centimeter blocks) have fewer incidences of heartburn. When they do experience indigestion, the episodes are shorter, symptoms are fewer, and the acid clears more quickly.

The side you sleep on can also affect heartburn. Experts aren’t quite sure why, but it seems that lying on the right side causes symptoms to last longer than lying on the left side.

If You Go Prescription

Both histamine blockers and PPIs began as prescription remedies but are now available over the counter, which leaves doctor-prescribed options relatively limited.

“The majority of prescription medications are PPIs and do not differ substantially from the OTC version,” says Jeffrey Tipton, DO, MPH, medical director at CareMore in Cerritos, Calif. “Patients are sometimes prescribed medications such as Reglan that increase motility in the GI tract. Like most medications, these are helpful for some and not for others.”

If It’s More Than Heartburn

One of the most important tips for dealing with heartburn is making sure your symptoms aren’t signs of anything more serious. Sometimes heart and lung issues can seem like acid reflux, says Wyneski, so pay attention to your pain. If you feel pain radiating into the neck or down the arm, severe palpitations, or lightheadedness, or if you’re passing out, seek medical attention.

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Throw Away the Tums! Healthy Alternatives to Antacids

Heartburn? Upset stomach? The answer to these ailments is all to often popping an antacid such as Tums. And why not? they are just over the counter meds that might even give you a dose of calcium along with it. In fact, more and more often, I’m seeing the recommendation to take Tums with calcium as a supplement with the added “stomach soothing” benefit. Or, for those that have ongoing heartburn, a class of drugs known as “proton pump inhibitors” (PPI’s) such as Prilosec, are recommended for relief. These drugs are meant for short-term use (though in my opinion, are far over-prescribed), but end up being used long-term. This post is aimed to explain the downside to taking antacids and offer some dietary strategies to provide you with some relief with the big take-away being, get to the root of your heartburn for long term relief and leave the meds at the pharmacy.

The burning sensation, or “flame” that you feel in your stomach, chest, or traveling up your throat is heartburn and it can be caused by a number of different things. Often times it is experienced after eating spicy foods, drinking coffee, or eating fried foods. It is aggravated by stress and constipation and often the root of the problem is food sensitivities and/or (believe it or not) not producing enough acid, a condition called “hypochlorhydria”. The acid in your stomach is called hydrochloric acid (HCL) and it is critical for digestion and for killing pathogens that make us sick. The production of HCL signals a whole chain of digestive processes. Too little, such in cases of hypochlorhydria, and you risk not digesting properly (feeling extra full, constipated, not fully breaking down food to get the nutrition) and becoming ill. Specifically, HCL enhances the absorption of iron, zinc, copper, folic acid, B-vitamins, calcium and more. Did you note the calcium in there? Yes, so that calcium you are getting with the Tums that is reducing your stomach acid probably isn’t absorbing so well…

Here are some signs that make you think you might not be producing enough stomach acid:

So what should you do?

Before you head for the Tums, try these simply dietary strategies. And definitely get to a nutritionist that specializes in food sensitivities, digestive disorders and all things GI to help sort out what is going on beneath it all. Reflux and indigestion will return if you don’t get to the underlying the problem. Again, and in my experience, acid reflux is often related to food sensitivities.

*Note: Aloe Vera can interact with some medications and should not be taken by most children, pregnant or breastfeeding women. Discuss use with a healthcare professional.

There is a heck of a lot more you can (and should) do for long term relief -and to prevent damage to your digestive system. Make an appointment with me and we’ll figure it out together!

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The most popular acid reflux medications — proton pump inhibitors like Nexium, Prilosec and Prevacid, which are taken daily — can have serious side effects and “are not the benign drugs the public thinks they are,” said Dr. Shoshana J. Herzig of Harvard Medical School.

Over the past five years, the federal Food and Drug Administration has issued numerous warnings about proton pump inhibitors, saying that long-term use, defined as a year or more, increases the risk of hip, wrist and spine fractures (though studies have found an increase in bone fractures with use over shorter periods). Long-term use can also lead to low levels of magnesium in the blood, which can precipitate seizures, arrhythmias and muscle spasms, according to the F.D.A. The deficiency cannot always be corrected with supplements, and patients who take other drugs like digoxin or diuretics, which can also cause low magnesium levels, should avoid proton pump inhibitors.

The use of these inhibitors for any period of time is also associated with an increase of intestinal infections and a higher risk of Clostridium difficile-associated diarrhea, a potentially life-threatening disease. An F.D.A. advisory warns patients who use these drugs to contact their health care providers immediately if they develop persistent diarrhea that does not improve.

Several studies have also reported that proton pump inhibitors increase the risk for pneumonia in hospital patients; a similar increase was not seen among patients taking a different type of acid-reflux drug called a histamine-2 receptor blocker (a drug like Pepcid or Zantac), Dr. Herzig said.

Long-term P.P.I. use may reduce the absorption of other important nutrients, vitamins and minerals besides magnesium, such as calcium, iron and vitamin B12, and has been linked with anemia. P.P.I.s can also interact with other medications, and the F.D.A. has warned heart attack and stroke patients that the P.P.I. omeprazole (Prilosec) weakens the effectiveness of the anticlotting agent clopidogrel (Plavix).

Stomach acid plays an important role in breaking down food and absorbing nutrients, and also kills bacteria and microbes. Long-term maintenance use of acid-suppressing drugs like proton pump inhibitors may disrupt these processes and make people more susceptible to both infections and nutritional deficits, experts say.

Taking antacids like Tums, Rolaids, Pepto-Bismol or Milk of Magnesia episodically to relieve heartburn is unlikely to have these effects, and while H2 blockers are known to have side effects like headaches, constipation and nausea, their long-term use has not been studied as extensively as that of proton pump inhibitors.

“Certain people with conditions like Barrett’s esophagus should be on long-term acid suppression,” Dr. Herzig said, referring primarily to P.P.I.s, “but the majority of people with heartburn and reflux should not be on these drugs long-term.”

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