Got heartburn? Doctor breaks down medications that might help

ATLANTA - Dr. Cameron Body, a gastroenterologist with Wellstar Health System in LaGrange, with sees a lot of patients with chronic heartburn, or acid reflux.

"We think that about 25% of Americans have reflux at least once a week," Dr. Body says.

If you're having acid reflux a couple of times a week, you may have gastroesophageal reflux disease, or GERD, which occurs when acid from the stomach backs up through the esophagus, causing burning chest pain.

Lifestyle changes can help, like losing weight, sleeping with your head elevated, avoiding lying down after meals and steering clear of fatty foods and chocolate and onions, which can exacerbate acid reflux.

If you're tried all those things, with no relief, Body says, you may need an over-the-counter or prescription heartburn medication.

"Most of the anti-reflux medicines that you think of: Nexium, Prilosec, Prevacid are all in the class of proton pump inhibitors."

PPIs decrease the production of stomach acid.

Dr. Body says they are usually her first choice for patients with frequent acid reflux.

"They're easy to take, in general, and they're very well tolerated, and they're effective," she says.  "Some of those long term complications that we worry about with acid reflux are minimized by being on a PPI.  So, unless I have a great reason for not putting a patient on one, that's kind of my go-to medicine."

But, Dr. Body says, PPIs are typically not highly effective as an on-demand treatment.  

"In general, you need to be on these medicines a little more chronically to get the maximum efficacy," she says.  "But, if patients only have symptoms when they go out to Mexican and eat salsa, then it's fine to take their pill beforehand, go have your dinner, enjoy it, and hopefully not have some of the unwanted consequences of that delicious meal."

Another class of heartburn drugs is H2 inhibitors like Pepcid and Zantac, which also can suppress stomach acid production.
 
Still, Dr Body says, over time, our stomachs can overcome that acid suppression.

"Typically, within 2 to 6 weeks, your body or stomach is back to producing the same level of acid it was before," she says.  "So, those medicines do work, but they typically don't provide long-lasting relief."

Dr. Body says all medications can have side effects.

So, I always counsel my patients with acid reflux, we want to make sure you're on the lowest effective dose that gives you symptomatic relief," she says.

If you are experiencing chronic or severe heartburn symptoms, talk to your health provider.

Over time, untreated acid reflux can lead to damage or more serious complications, Dr. Body says.