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Digestive Health

Using Over-the-Counter Medicines for Heartburn

Summary & Participants

Many people complain of heartburn. But in most cases, it's remarkably easy to find relief. Listen to experts explain why getting rid of heartburn may be simpler than you think.

Medically Reviewed On: June 10, 2008

Webcast Transcript

JOHN HORN, PharmD: Antacids really are the best treatment for an acute episode of heartburn. So if one has had a big dinner and at 10:00 at night they develop heartburn or two in the afternoon after lunch they get heartburn, the treatment for that episode of heartburn is an antacid.

A. MARK FENDRICK, MD: Antacids work by neutralizing the acid that already exists in the stomach. So these drugs work very quickly and will eliminate this excess acid.

JOHN HORN, PharmD: Their limitation is that they don't last very long, so that when you take an antacid you can treat the episode of heartburn that you're having right now, but it's not going to do much to prevent an episode happening later in the day or tomorrow.

ANNOUNCER: Rather than neutralize acid that already exists, another approach toward heartburn is to reduce acid production with an acid blocker, for longer-term relief.

JOHN HORN, PharmD: There's a cell in the stomach called a parietal cell, and that parietal cell makes acid. And there are a number of different things that stimulate that parietal cell, and one of them is histamine. And so there's this receptor called the histamine receptor that will stimulate the parietal cell to make acid. And H2 blockers simply block that receptor and prevent histamine from stimulating the parietal cell, thus reducing the amount of acid that's made.

A. MARK FENDRICK, MD: H2 blockers, particularly for intermittent and mild heartburn, are very effective and have been shown in studies to prevent these heartburn events and symptomatic events from occurring.

ANNOUNCER: But it takes an hour, or longer, for an H2 blocker to take full effect. What happens if a person wants to stop heartburn immediately, and also wants longer-term relief?

A. MARK FENDRICK, MD: For an individual experiencing a heartburn episode, I think the combination of an antacid that works quickly by neutralizing acid and an H2 blocker, which prevents the further production of acid, to be an ideal treatment choice.

ANNOUNCER: Another type of acid blocker is called a Proton pump inhibitor, or PPI, may be in order. H2 blockers cut down on acid production in the parietal cells that line the stomach. PPIs, working through another mechanism, come close to shutting acid production down altogether.

JOHN HORN, PharmD: PPIs are longer acting so that you don't have to be quite as careful about your timing with relationship to meals. And then secondly, a proton pump inhibitor might be effective in a patient in whom they had tried an H2 blocker but had not gotten complete relief. In other words, they were still having symptoms while taking their H2 blocker and needed something a little more potent to suppress enough acid to eliminate their symptoms.

ANNOUNCER: PPIs take longer than H2 blockers to start working, and they must be taken for a number of days before their maximum effectiveness is achieved.

EVELYN HERMES DeSANTIS, PharmD: In terms of the role of a proton pump inhibitor, you're really looking for a patient who has had multiple episodes of heartburn that are not being controlled by an H2 blocker to be turning to a proton pump inhibitor.

ANNOUNCER: Antacids, H2 blockers, proton pump inhibitors: There are many type of heartburn medications available.

What should be reassuring to the millions of people who suffer from occasional heartburn is the knowledge that many products offer good relief. And many are conveniently available, over the counter.

A. MARK FENDRICK, MD: Most people with heartburn can achieve very high-quality relief with agents that are available without the need of prescription.

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