If you get mild heartburn occasionally, an antacid bought over the counter could relieve the symptoms. However, if these symptoms persist and you start getting heartburn regularly, your body could be telling you to change your lifestyle. Constant heartburn could also be a symptom of something worse than an unhealthy lifestyle, such as peptic ulcers or stomach cancer. If you get heartburn regularly, you need to see your doctor and have the symptoms checked out.
Acid reducing medications can broadly be divided into two groups: H2 antagonists (such as Zantac, Tagamet) and proton pump inhibitors (PPIs, including Controloc, Losec, Nexiam, Pantoloc, Pariet, Lanzor, Ulzec).
These are the most commonly used drugs for heartburn. They are available from chemists, 24-hour shops and supermarkets. Antacids (anti-acids) neutralise the acid in your stomach on the short term.
They are simple alkalis and examples of these are aluminium hydroxide, magnesium trisilicate and sodium bicarbonate. The first of these could cause constipation in certain people, and the second diarrhoea. Most people experience no side-effects. The last of these, sodium bicarbonate, contains salt and should therefore be avoided by people with kidney disease, heart disease or high blood pressure.
Some antibiotics also should not be taken in conjunction with antacids. This is usually indicated on the label.
H2 receptor antagonists
These drugs reduce heartburn by reducing the amount of acid your stomach produces. Most of these drugs are only available on prescription, but there are some that can be obtained over the counter. These are usually only enough for two weeks and are somewhat weaker than those obtained on prescription.
These drugs should not be taken without the knowledge of your doctor, especially if you are taking medication to control chronic asthma, epilepsy or medication to thin the blood. The drugs that do not combine with H2 receptor antagonists are warfarin, phenytoin and aminophylline.
H2 receptor antagonists should be taken just before the time you would usually expect to get heartburn.
These drugs are much stronger than and thus more effective than the H2 antagonists. Both PPIs and H2 antagonists are very safe.
(Reviewed Jan 2011 by Dr Maarten Prins, gastroenterologist, Panorama MediClinic, Cape Town.)
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