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Heartburn and GERD: How to treat nausea and stomachaches

If you ever feel a burning sensation rise from your stomach into your chest and throat after a meal, you’re far from alone. More than 60 million Americans experience the discomfort of heartburn at least once a month, according to the American College of Gastroenterology.

We created this guide to better help you understand what heartburn is, and most importantly, how you can fix it. The good news is, there are plenty of effective treatment options available to help ease and prevent the burn and discomfort. Be it using over-the-counter or prescription medications, or making a few lifestyle changes, we’ve got you covered.

What is heartburn?

Heartburn, or gastroesophageal reflux, occurs when excessive amounts of acid reflux (read: move backward) into the esophagus, a muscular tube connecting the stomach to the throat. This usually occurs when a small muscle between the esophagus and stomach starts to relax, allowing stomach acid to migrate up.

What does heartburn feel like?

Common symptoms of heartburn are described as a feeling of burning pain or discomfort that moves up from the chest toward the neck and throat. In some cases, people experience a bitter or sour taste in the back of their throats. Despite the name, it does not have anything to do with your heart. Rather it’s the sensation of acid irritating your tissues.

What causes heartburn?

It is more common to experience heartburn after consuming a large meal, especially one high in fats. The internal pressure caused by a full stomach can force acid into the esophagus, which can cause symptoms. Being overweight can worsen this pressure and make heartburn more likely. Fatty foods and overeating can slow down digestion, which also contributes to acid reflux.

If you’re starting to feel the burn, or have just had a large, indulgent meal, you may want to avoid lying down on the couch, too. When we’re upright, gravity works in our favor to stop stomach acid moving upward. However, if you lie down, you’re more likely to experience heartburn as gravity cannot stop the acid flowing into your esophagus.

Is it heartburn or something more?

Almost everyone will experience heartburn symptoms at some point or another, especially after eating a large meal, with symptoms sometimes lasting a few hours. However, some people experience chronic heartburn, with symptoms happening more than two times a week. In this case, you may have a more severe medical condition called gastroesophageal reflux disease, or GERD.

GERD occurs in people with a weak muscular valve called the lower esophageal sphincter (LES). It relaxes too often and lets stomach acid move up the esophagus.

It’s estimated that 20% of the American population has GERD, which is why awareness initiatives such as the GERD Awareness Week are so important. The 2019 GERD Awareness Week ran from Nov. 17-24, so add next year’s to your calendar to stay updated.

How can I get rid of heartburn?

Fortunately, there are many effective treatment options available for people who experience heartburn. Many people find relief with both prescription and over-the-counter medication, a few lifestyle changes, as well as with some natural and home remedies.

Popular over-the-counter medications for heartburn include antacids, like Tums or Rolaids, that work to neutralize stomach acid and acid indigestion. Some people prefer acid blockers, which reduce the actual amount of stomach acid produced. These include Axid AR, Pepcid AC, Prilosec OTC, and Tagamet HB.

RELATED: Prevacid vs Prilosec

If your heartburn is more regular or severe however, and over-the-counter options aren’t effective, you may require prescription medication. These are usually stronger versions of the over-the-counter brand options, as well as proton pump inhibitor (PPI) drugs including Prevacid and Nexium.

One lifestyle change that many people report as effective for reducing their indigestion and heartburn is to practice only eating until full.

It’s also a good idea to get to know what foods trigger your heartburn and avoid them when possible. Foods that are known to trigger heartburn include coffee, alcohol, soft drinks, spicy foods, tomatoes, chocolate, peppermint, onions, and any high-fat foods.

It can also help to avoid laying down for a while after eating your meal and instead choosing to go for a walk. This aids digestion and helps gravity to work in your favor.

What is the best heartburn relief medicine?

Check out our quick-reference chart.

Heartburn relief medicine
Drug name Drug class Over-the-counter or prescription Forms How it works
Tums (calcium carbonate) Antacid OTC Chewable tablet, tablet, suspension Neutralizes stomach acid
Rolaids (calcium carbonate and magnesium hydroxide) Antacid OTC Chewable tablet, tablet, lozenge Neutralizes stomach acid
Maalox (aluminum hydroxide, magnesium hydroxide, and simethicone) Antacid OTC Chewable tablet, liquid Neutralizes stomach acid
Emetrol (phosphorated carbohydrate) Antiemetic OTC Liquid Decreases stomach contraction
Pepto Bismol (bismuth subsalicylate) Antacid, antidiarrheal OTC Chewable tablet, suspension Protects esophagus from acid
Axid (nizatidine) H2 (histamine-2) blocker Rx and OTC Tablet, capsule Blocks production of stomach acid
Pepcid (famotidine) H2 (histamine-2) blocker Rx and OTC Tablet Blocks production of stomach acid
Tagamet (cimetidine) H2 (histamine-2) blocker Rx and OTC Tablet Blocks production of stomach acid
Prevacid (lansoprazole) Proton pump inhibitors (PPIs) Rx and OTC Delayed-release capsule Blocks production of stomach acid
Nexium (esomeprazole magnesium) Proton pump inhibitors (PPIs) Rx and OTC Delayed-release capsule Blocks production of stomach acid
Prilosec (omeprazole) Proton pump inhibitors (PPIs) Rx and OTC Delayed-release capsule Blocks production of stomach acid

Rolaids vs Tums

Rolaids and Tums are two of the most popular over-the-counter antacids available to treat indigestion and heartburn. They work by buffering and neutralizing the effects of stomach acid that creeps up the esophagus.

So how are they different? The active ingredient in Tums is solely calcium carbonate, whereas Rolaids is a combination of calcium carbonate and magnesium hydroxide. Both are great options for mild heartburn and taken on demand.

Although considered highly safe, they share similar side effects including constipation, dry mouth, metallic taste in the mouth, increased urination, and stomach pains. Due to the magnesium hydroxide in Rolaids, there is also the added potential side effect of diarrhea.

What happened to Mylanta?

For many years, especially in the 1990s, Mylanta was a popular product used to alleviate the symptoms of heartburn. However, in 2010, the over-the-counter antacid was voluntarily recalled due to traces of alcohol being found in the product.

According to the manufacturer, Johnson & Johnson, the product was recalled so it could be relabelled with better accuracy, not because of any risk to alcohol absorption or adverse effects.

In 2016 Mylanta was reintroduced to the market and deemed safe to use as an antacid.

Possible side effects of heartburn medicine

As with all medications, there is always the risk of some side effects. This, of course, includes heartburn and indigestion medicine.

Some side effects people report when taking antacid and acid blocker (also known as proton pump inhibitors or PPIs) medications for heartburn and GERD include:

  • Diarrhea
  • Constipation
  • Flatulence (gas)
  • Stomachaches and vomiting
  • Headache
  • Fever

Before starting any new medication, it’s always important to consult with your doctor or gastroenterologist and disclose any other medicines you are currently taking, as there is always the risk that some medications have negative interactions when taken together.

Heartburn during pregnancy

Heartburn during pregnancy is especially common, as the increased production of the hormone progesterone can cause the valve separating the stomach from the esophagus to relax.

It’s more common during the third trimester of pregnancy when the growing baby and uterus put added internal pressure on the stomach, pushing stomach acid upward.

You can prevent heartburn during pregnancy by eating more smaller meals during the day rather than less frequent, larger meals, waiting an hour—or so—after eating before lying down, and avoiding trigger foods that are spicy, high in fat, and greasy.

Most over-the-counter antacid medications are safe to use during pregnancy, but it’s always best to speak with your healthcare provider and read the label before starting any medication or treatment during pregnancy.