Diseases & Conditions

Heartburn Treatment

Over-the-counter liquid antacids are helpful in treating occasional heartburn. If your symptoms persist, do not respond to treatment, or occur frequently, you need to see a physician for testing and treatment.

A visual examination of the esophagus, known as an endoscopy, may be necessary. Sometimes this test shows that the lining of the esophagus is severely inflamed and irritated by stomach acid. This condition, known as esophagitis, may lead to bleeding and difficulty in swallowing. Medical treatment for this condition may be necessary. This usually involves blocking acid production in the stomach or strengthening the lower esophageal sphincter to help close off the opening to the stomach.

Non-prescription treatments
  • Antacids neutralize excess stomach acid to relieve heartburn, sour stomach, acid indigestion and stomach upset. They are also occasionally prescribed to help relieve the pain of ulcers. Some antacids also contain simethicone, an ingredient that helps eliminate excess gas. Examples of antacids include Tums, Rolaids, and Maalox.

You should take antacids exactly as directed by your doctor, or according to the manufacturer's directions. If you are using the tablets, chew them well before swallowing for faster relief.

Some antacids contain magnesium or sodium bicarbonate, ingredients that may have a laxative effect.

Side effects include constipation, diarrhea, white or pale bowel movements, and stomach cramps. Serious side effects can occur with an overdose or overuse of antacids.

  • Acid blockers. Pepcid AC, Tagamet HB, Zantac 75 (ranitidine), and Axid AR are H 2 blockers or acid-blocking drugs that are available without a prescription (over-the-counter). These products are for relief of heartburn, acid indigestion, and sour stomach. Acid blockers work by reducing the production of stomach acid.

Take these medications according to the directions on the package, or as advised by your doctor.

Possible serious side effects that need to be reported to your doctor right away include confusion, chest tightness, bleeding, sore throat, fever, irregular heartbeat, weakness, and unusual fatigue. Other, less serious side effects include headache, dizziness, and diarrhea. These are usually temporary and will likely go away on their own.

When combined with lifestyle changes, these over-the-counter remedies relieve symptoms in about 25% of heartburn sufferers. People who have more severe heartburn symptoms that aren't relieved with these medications or who have been using these drugs for more than two weeks should contact their physician.

Prescription medications
  • Acid blockers. In prescription form (usually higher doses), Zantac, Tagamet, Pepcid, and Axid can generally relieve heartburn and treat gastroesophageal reflux disease. They also may be used for other conditions as determined by your doctor.
  • Proton pump inhibitors. Depending on the source of your problem, your physician can prescribe medications that more effectively block acid production. These medications are called proton pump inhibitors, and include Aciphex, Nexium, Prevacid, Prilosec, and Protonix.
  • Promotility agents. The drug Reglan speeds up the digestion process and decreases the amount of stomach acid that splashes back into the esophagus.

When you should contact your doctor

You should contact your health-care provider for any of the following reasons:

  • Your heartburn won't go away.
  • You are having difficulty swallowing.
  • Your heartburn is causing you to vomit.
  • You have been using antacid medications for more than two weeks, and you still have heartburn.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/1/2013…#9624