Exit

Health Condition

Gastroesophageal Reflux Disease

  • Antacids & Acid Reducers

    If you or a family member occasionally suffers from heartburn or acid indigestion, antacids may offer temporary relief. For more frequent issues, consider acid reducers like ranitidine or omeprazole. It’s important to see your doctor if symptoms persist, as they could be early warning signs of a more serious condition. Keep the following in mind as you consider the right antacids and acid reducers for you:

    • Reduced stomach acidity may result in an impaired ability to digest and absorb certain nutrients, such as iron, magnesium, and B vitamins.
    • Since stomach acidity normally kills ingested bacteria, antacids and acid reducers may increase your vulnerability to infection.
    • They may also change how you absorb certain medications, so use carefully and talk with your doctor if you have concerns.
    • Antacids

      What they are: Antacids are chewable tablets, effervescent drink powders, liquids, and syrups containing one or multiple active ingredients shown to temporarily neutralize stomach acid and treat the symptoms of heartburn.

      • Sodium bicarbonate, also known as baking soda. Some antacids combine it with alginic acid, a gelling agent, to create a barrier which prevents stomach acid from refluxing back up into the esophagus. Effervescent formulas with aspirin provide added pain relief.
      • Calcium carbonate, typically found in chewable tablets.
      • Aluminum hydroxide and/or magnesium hydroxide, usually found in gel or liquid form.

      Why to buy: Antacids may provide immediate, temporary relief (1 to 2 hours) from minor symptoms of heart burn and indigestion.

      Things to consider: Minor side effects include diarrhea, constipation, and flatulence. Generally, medications containing aluminum or calcium are likeliest to cause constipation; those containing magnesium are likeliest to cause diarrhea. Some products combine these ingredients in order to help prevent unpleasant side effects. Consuming excess calcium carbonate can be hazardous, so read labels carefully.

    • Acid Reducers/H2 Blockers

      What they are: H2 receptor antagonists, or “blockers,” are used to decrease stomach acid by preventing histamine from stimulating acid production. There are four FDA-approved variations—cimetidine, ranitidine, famotidine, and nizatidine—all available over the counter.

      Why to buy: H2 blockers are an effective and well-tolerated treatment for heartburn and indigestion. Many can be taken before meals to prevent heartburn, and effects last longer than antacids.

      Things to consider: Cimetidine has the most instances of adverse reactions in this drug class, including headache and dizziness. Cimetidine interacts negatively with many other medications, so read labels and talk with your doctor or pharmacist.

    • Proton-Pump Inhibitors (PPIs)

      What they are: PPIs are the most potent and effective treatments available for frequent heartburn and indigestion. Available by prescription and over the counter, omeprazole and lansoprazole are the most common active ingredients.

      Why to buy: PPIs offer effective, long-lasting treatment of acid indigestion, heartburn, and ulcers by significantly reducing stomach acid production with few side effects. Most PPIs do not provide immediate relief, but take hours or days to become effective and are taken for weeks at a time. If you need both immediate and long-lasting results, look for combination products with an antacid and acid reducer.

      Things to consider: Acid reducers are not meant for long-term use. The FDA advises that no more than three 14-day treatment courses be used in one year unless directed by a doctor. Side effects may include headache, nausea, diarrhea, abdominal pain, fatigue, and dizziness. High-dose or long-term PPI use may lead to increased risk of bone fractures, and decreased vitamin B12 absorption, potentially leading to vitamin B12 deficiency.

  • Natural Digestion Aids

    From indigestion to constipation, digestion woes can ruin anyone’s day. If you suffer with these issues from time to time, a natural digestion aid may be just what you need to get your body back on track. Our guide to digestion aids will help you find the right products to meet your health and lifestyle needs. Keep the following in mind as you choose a digestion aid.

    • If you haven’t changed your eating habits and you’re experiencing new symptoms such as constipation, diarrhea, or heartburn on a regular basis, consult your doctor. These symptoms may signal a more serious health problem.
    • When selecting a product, consider medications you use and health conditions you have. Consult your doctor or pharmacist if unsure about whether any particular digestion aid is safe for you.
    • When using multiple products, always compare ingredients to avoid accidentally doubling up on any one particular active ingredient.
    • Read labels carefully to ensure you pick the right products to meet your particular digestion issues; some products are designed to address several problems at once, others only one issue at a time.
    • If you are pregnant or nursing, consult your doctor before using digestion aids.
    • Do not use any products for which a complete ingredient list is not provided.
    • Teas

      What they are: Teas to address a particular digestion issue contain an ingredient, or combination of ingredients, such as:

      • Ginger, fennel, fenugreek, or chamomile for nausea, indigestion, and heartburn (acid reflux)
      • Peppermint for nausea (good for nausea, but may worsen heartburn)
      • Parsley or fennel for gas and bloating
      • Slippery elm or meadow sweet for intestinal discomfort and spasms
      • Aloe, senna, cascara, or burdock root for constipation

      Why to buy: Herbal teas are generally safe and easy to use, offer gentle relief for occasional digestion woes, and are relatively inexpensive.

      Things to consider: Teas for constipation can have strong laxative effects in some people; start with a quarter to half cup serving and see how your body responds. Increase the dose as needed to relieve constipation. Pregnant women, people with kidney problems, high blood pressure, or heart disease, or those who are taking diuretic medications should consult their doctor before using digestion teas.

    • Herbal Capsules

      What they are: Natural digestion aids are available in capsule or tablet form and contain many of the same herbs found in digestion aid teas.

      Why to buy: Digestion aid capsules are more convenient; they can be carried with you and taken anytime, without the need to boil water to make tea. Capsules may deliver a more concentrated dose of the active ingredient than tea.

      Things to consider: As with teas, products for constipation can have strong laxative effects, so start slow and increase the dose only as needed. Consult your doctor or pharmacist before using these products if you are pregnant, or have kidney problems, high blood pressure, or heart disease, or take diuretic medications.

  • Children's Digestion Aids

    Illness, nerves, trying new foods—all sorts of things may throw your little one’s digestive system off track and cause constipation or diarrhea. Comfort your kids with safe, gentle, and effective products to help them go, or help them stop. And help keep your kids regular with a healthy diet containing plenty of fiber and water.
    • Stool Softeners & Laxatives

      What they are: Stool softeners and osmotic laxatives are kid-friendly, stimulant-free products that ease constipation—from flavored powders you mix with juice, to chewable tablets, to rectal suppositories.

      Why to buy: Stool softeners offer gentle, gradual relief from occasional constipation. Powders with oral docusate sodium also prevent dry, hard stools and generally work in 12 to 72 hours. Most chewable tablets contain the non-stimulant laxative magnesium hydroxide, known as “milk of magnesia,” and take effect in 30minutes to six hours. For more immediate relief, liquid glycerin suppositories are available in easy-to-use disposable applicators.

      Things to consider: Ask a doctor before your child uses stool softeners or laxatives if they’re experiencing abdominal pain, nausea, or vomiting; or have a sudden change in bowel habits lasting more than two weeks. These could be symptoms of a more serious condition. Stop using laxatives and stool softeners and consult a doctor if your child has rectal bleeding or still has no bowel movement after use.

    • Anti-Diarrheal Products

      What they are: Smaller dosage amounts of most adult anti-diarrheal medicines are safe and effective for children; recommended amounts are usually indicated on the label. Loperamide hydrochloride is the most common active ingredient and is safe for use by children six and older. It’s available in caplets, soft gels, and liquids. Chewable tablets and flavored liquids containing bismuth subsalicylate are safe for children over 12.

      Why to buy: Anti-diarrheals help ease stomach discomfort and stop diarrhea symptoms.

      Things to consider: Most anti-diarrheal products should not be used in children under six unless directed by a doctor. Children and teenagers who have or are recovering from chicken pox or flu-like symptoms should not use bismuth subsalicylate due to risk of Reye’s syndrome. Remember, when children suffer from diarrhea, they need to drink plenty of fluids. There are many convenient over-the-counter remedies for dehydration including popsicles enhanced with much-needed electrolytes.

  • Smoking Cessation Products

    Many things motivate people to quit tobacco: being a good role model, wanting to reduce others’ exposure to second hand smoke, saving money, and wanting to feel better and improve health. Whatever your reason, keep in mind that quitting cold turkey is the least successful method for kicking cigarettes for good. Fortunately, many over-the-counter and prescription quit aids have been developed that may significantly improve your odds of success. As you figure out which quit-smoking aids best meet your needs, keep the following in mind:

    • Some treatments to stop smoking are covered by health insurance. Check with your carrier to see.
    • Some products are available both over the counter (behind the pharmacy counter) and with a prescription. Ask your health insurance about whether you need a prescription for coverage or reimbursement.
    • Try, try, and try again. People who successfully quit smoking rarely do so on the first attempt. If you’ve tried before without success, don’t be discouraged. Consider a different quit aid—the nicotine patch instead of gum, or adding in a prescription medication—and evaluate what worked and didn’t work to keep you on track during past attempts to quit.
    • Start with your doctor, nurse, or pharmacist. They can offer invaluable advice and connect you with programs for people trying to quit, including support groups and other resources. Consider taking advantage of these supports, because most people do best when they combine quit-smoking products with behavior change programs.
    • When selecting a product, consider your current medications and health conditions. Consult your doctor or pharmacist if unsure about whether any particular smoking cessation product is safe for you.
    • Use nicotine replacement carefully and follow all package directions. Some people load up on patches, gum, and sprays yet continue to smoke at the same time. This can overload your system with nicotine, resulting in jitters, rapid heart rate, high blood pressure, and trouble sleeping. Some products can be used together, so ask your doctor or pharmacist what’s best for you.
    • Nicotine Patches

      What they are: Nicotine patches are similar to an adhesive bandage; you place one on your skin and it releases a constant amount of nicotine into the body while you wear it. They come in different sizes, with larger sizes delivering more nicotine.

      Why to buy: Nicotine replacement patches are available over the counter or with a prescription, and typically cost less per day than a pack of cigarettes. Patches are convenient and easy to use and can be removed during sleep to lessen the likelihood of insomnia. Due to the constant, slow release of nicotine, you are not likely to develop a craving for a patch; it doesn’t provide the intense delivery of a cigarette.

      Things to consider: Unlike smoking, which delivers a large dose of nicotine to your body within seconds, nicotine from a patch can take up to three hours to get into the body. For this reason, putting on a patch when a cigarette craving strikes is not effective. The nicotine patch reduces smoking withdrawal symptoms, such as lack of concentration and irritability.

    • Nicotine Gum

      What they are: Nicotine replacement gums are available over the counter or with a prescription and typically cost much less per day than a pack of cigarettes. Gum comes in different strengths to provide the amount of nicotine you need, based on your previous smoking habits.

      Why to buy: Gums are relatively convenient and easy to use, although you must remember to keep yours with you, because it must be chewed frequently to deliver enough nicotine to manage cravings. Though it cannot get nicotine into your body quite as quickly as a cigarette, gum delivers nicotine within minutes, which is far faster than a patch.

      Things to consider: Nicotine gum should not be used with cigarettes and you should not eat or drink for 15 minutes before or while using the gum. To chew enough gum to quell cravings, most people need between 15 and 30 pieces per day, chewed off and on for about 30 minutes. Nicotine gum should not be chewed continuously like regular gum and should never be swallowed. It is chewed a few times to break it down and then placed in between your gum and cheek for 10 or 15 minutes, chewed again for a bit, then put back into the cheek. Continuous chewing may cause stomachaches.

    • Lozenges & Lollipops

      What they are: Nicotine replacement lozenges and lollipops are available over the counter or with a prescription. They may cost a bit more than patches or gum, but typically less than a pack of cigarettes. Lozenges and lollipops come in different strengths to provide the amount of nicotine you need, based on your previous smoking habits.

      Why to buy: Some people don’t like to chew gum and prefer sucking on a candy to replace nicotine when quitting smoking. These products are relatively convenient, but you must remember to keep them on hand to use throughout the day. Lozenges and lollipops deliver nicotine within a few minutes, similar to gum.

      Things to consider: Nicotine lozenges and lollipops should not be used with cigarettes and you should not eat or drink for 15 minutes before or while they are in your mouth. Nicotine lozenges and lollipops should not be chewed or swallowed as this can lead to heartburn and stomachaches. Some people find these products irritate the mouth and throat.

    • Nicotine Nasal Sprays & Inhalers

      What they are: These products deliver nicotine through a spray into the nose or are inhaled through the mouth. They are available by prescription only.

      Why to buy: Nicotine nasal sprays and inhalers deliver nicotine as quickly as a cigarette, making them particularly helpful for people who are highly dependent on tobacco. For the person who smokes more than a pack of cigarettes per day, these products may be very effective.

      Things to consider: You need a prescription to obtain a nicotine spray or inhaler. Sprays cost about the same as gums and patches, but inhalers can be more expensive. They may be covered by insurance, which can help reduce the cost.

    • Non-Nicotine Prescription Medications

      What they are: Two different non-nicotine prescription medications may help people quit smoking by reducing the desire to smoke.. These are bupropion (brand name Zyban) and varenicline (brand name Chantix).

      Why to buy: These medications may significantly increase the quit smoking success rate beyond using nicotine replacement alone. They can be used in conjunction with nicotine replacement, further increasing success rates of quitting.

      Things to consider: Like all prescription medications, these drugs can have side effects. Many people tolerate them well, but some people experience very serious side effects, particularly from varenicline, which in some people causes hostility, agitation, anger, aggression, depressed mood, anxiety, paranoia, confusion, mania, or suicidal thoughts or actions. These can develop when a person begins taking the medication, after several weeks of treatment, or after stopping the varenicline. Insurance may not cover the cost of these medications.

References

1. Gignoux M, Launoy G. Recent epidemiologic trends in cancer of the esophagus. Rev Prat 1999;49:1154-8 [in French].

2. Morgan AG, Pacsoo C, McAdam WA. Maintenance therapy: A two year comparison between Caved-S and cimetidine treatment in the prevention of symptomatic gastric ulcer. Gut 1985;26:599-602.

3. Kassir ZA. Endoscopic controlled trial of four drug regimens in the treatment of chronic duodenal ulceration. Ir Med J 1985;78:153-6.

4. Glick L. Deglycyrrhinated licorice in peptic ulcer. Lancet 1982;ii:817 [letter].

5. Das SK, Gulati AK, Singh VP. Deglycyrrhizinated licorice in aphthous ulcers. J Assoc Physicians India 1989; 37:647.

6. Markham C, Reed PI. Pyrogastrone treatment of peptic oesophagitis: analysis of 104 patients treated during a 3 1/2-year period. Scand J Gastroenterol Suppl 1980;65:73-82.

7. Reed PI, Davies WA. Controlled trial of a carbenoxolone/alginate antacid combination in reflux oesophagitis. Curr Med Res Opin 1978;5:637-44.

8. Young GP, Nagy GS, Myren J, et al. Treatment of reflux oesophagitis with a carbenoxolone/antacid/alginate preparation. A double-blind controlled trial. Scand J Gastroenterol 1986;21:1098-104.

9. Maxton DG, Heald J, Whorwell PJ, Haboubi NY. Controlled trial of pyrogastrone and cimetidine in the treatment of reflux oesophagitis. Gut 1990;31:351-4.

10. Golan R. Optimal Wellness. New York: Ballantine Books, 1995, 373-4.

11. Chevrel B. A comparative crossover study on the treatment of heartburn and epigastric pain: Liquid Gaviscon and a magnesium-aluminum antacid gel. J Int Med Res 1980;8:300-3.

12. Golan R. Optimal Wellness. New York: Ballantine Books, 1995, 373-4.

13. Golan R. Optimal Wellness. New York: Ballantine Books, 1995, 373-4.

14. Chevrel B. A comparative crossover study on the treatment of heartburn and epigastric pain: Liquid Gaviscon and a magnesium-aluminum antacid gel. J Int Med Res 1980;8:300-3.

15. Golan R. Optimal Wellness. New York: Ballantine Books, 1995, 373-4.

16. Chevrel B. A comparative crossover study on the treatment of heartburn and epigastric pain: Liquid Gaviscon and a magnesium-aluminum antacid gel. J Int Med Res 1980;8:300-3.

17. Golan R. Optimal Wellness. New York: Ballantine Books, 1995, 373-4.

18. Chevrel B. A comparative crossover study on the treatment of heartburn and epigastric pain: Liquid Gaviscon and a magnesium-aluminum antacid gel. J Int Med Res 1980;8:300-3.

19. Sigmund DJ, McNally EF. The action of a carminative on the lower esophageal sphincter. Gastroent 1969;56:13-8.

20. Wright LE, Castell DO. The adverse effect of chocolate on lower esophageal sphincter pressure. Dig Dis 1975;20:703-7.

21. Murphy DW, Castell DO. Chocolate and heartburn: Evidence of increased esophageal acid exposure after chocolate ingestion. Am J Gastroenterol 1988;83:633-6.

22. Feldman M, Barnett C. Relationships between the acidity and osmolality of popular beverages and reported postprandial heartburn. Gastroenterology 1995;108:125-31.

23. Moneret-Vautrin DA. Cow's milk allergy. Allerg Immunol (Paris) 1999;31:201-10 [review].

24. McLain BI, Cameron DJ, Barnes GL. Is cow's milk protein intolerance a cause of gastro-oesophageal reflux in infancy? J Paediatr Child Health 1994;30:316-8.

25. Forget P, Arends JW. Cow's milk protein allergy and gastro-oesophageal reflux. Eur J Pediatr 1985;144:298-300.

26. Staiano A, Troncone R, Simeone D, et al. Differentiation of cow's milk intolerance and gastro-oesophageal reflux. Arch Dis Child 1995;73:439-42.

27. Iacono G, Carroccio A, Cavataio F, et al. Gastroesophageal reflux and cow's milk allergy in infants: a prospective study. J Allergy Clin Immunol 1996:97:822-7.

28. Hill DJ, Cameron DS, Catto-Smith A, et al. Multiple food protein intolerance (MFPI) as a cause of reflux oesophagitis in infancy: results of a pilot study. J Allergy Clin Immunol 1998;101:S89 [abstract].

29. Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment. Ann Med 1999;31:272-81.

30. Nebel OT, Castell DO. Lower esophageal pressure changes after food ingestion. Gastroenterology 1972;63:778-83.

31. Becker DJ, Sinclair J, Castell DO, Wu WC. A comparison of high and low fat meals on postprandial esophageal acid exposure. Am J Gastroenterol 1989;84:782-6.

32. Penagini R, Mangano M, Bianchi PA. Effect of increasing the fat content but not the energy load of a meal on gasto-oesophageal reflux and lower oesophageal sphincter motor function. Gut 1998;42:330-3.

33. Pehl C, Waizenhoefer A, Wendl B, et al. Effect of low and high fat meals on lower esophageal sphincter motility and gastroesophageal reflux in healthy subjects. Am J Gastroenterol 1999;94:1192-6.

34. Ruhl CE, Everhart JE. Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization: the NHANES I Epidemiologic Followup Study. First National Health and Nutrition Examination Survey. Ann Epidemiol 1999;9:424-35.

35. Rodriguez S, Miner P, Robinson M, et al. Meal type affects heartburn severity. Dig Dis Sci 1998;14:157-9.

36. Castell DO. Physiology and pathophysiology of the lower esophageal sphincter. Ann Otol Rhinol Laryngol 1975;84:569-75 [review].

37. Stanghellini V. Relationship between gastrointestinal symptoms and lifestyle, psychosocial factors and comorbidity in the general population: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST). Scand J Gastroenterol Suppl 1999:231:29-37.

38. Locke GR 3rd, Talley NJ, Fett SL, et al. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med 1999;106:642-9.

39. Alaswad B, Toubas PL, Grunow JE. Environmental tobacco smoke exposure and gastroesophageal reflux in infants with apparent life-threatening events. J Okla State Med Assoc 1996;89:233-7.

40. Rodriguez S, Miner P, Robinson M, et al. Meal type affects heartburn severity. Dig Dis Sci 1998;14:157-9.

41. Halsted CH. Obesity: effects on the liver and gastrointestinal system. Curr Opin Clin Nutr Metab Care 1999;2:425-9 [review].

42. Lundam L, Ruth M, Sandberg N, Bove-Nielson M. Does massive obesity promote abnormal gastroesophageal reflux? Dig Dis Sci 1995;40:1632-5.

43. Fisher BL, Pennathur A, Mutnick JL, Little AG. Obesity correlates with gastroesophageal reflux. Dig Dis Sci 1999;44:2290-4.

44. Wilson LJ, Ma W, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol 1999;94:2840-4.

45. Merced CD, Rue C, Hanelin L, Hill LD. Effect of obesity on esophageal transit. Am J Surg 1985;149:177-81.

46. Fraser-Moody CA, Norton B, Gornall C, et al. Weight loss has an independent beneficial effect on symptoms of gastro-oesophageal reflux in patients who are overweight. Scand J Gastroenterol 1999;34:337-40.

47. Kjellin A, Ramel S, Rossner S, Thor K. Gastroesophageal reflux in obese patients is not reduced by weight reduction. Scand J Gastroenterol 1996;31:1047-51.

48. Kitchin LI, Castell DO. Rationale and efficacy of conservative therapy for gastroesophageal reflux disease. Arch Intern Med 1991;151:448-54. [review]

49. Galmiche JP, Letessier E, Scarpignato C. Treatment of gastro-oesophageal reflux disease in adults. BMJ 1998;316:1720-3.

50. Piesman M, Hwang I, Maydonovitch C, Wong RKH. Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter? Am J Gastroenterol 2007;102:2128-34.

51. Shawdon A. Gastro-oesophageal reflux and exercise. Important pathology to consider in the athletic population. Sports Med 1995;20:109-16. [review]

52. Soffer EE, Wilson J, Duethman G, et al. Effect of graded exercise on esophageal motility and gastroesophageal reflux in nontrained subjects. Dig Dis Sci 1994;39:193-8.

53. Clark CS, Kraus BB, Sinclair J, Castell DO. Gastroesophageal reflux induced by exercise in healthy volunteers. JAMA 1989;261:3599-601.

54. Yazaki E, Shawdon A, Beasley I, Evans DF. The effect of different types of exercise on gastro-oesophageal reflux. Aust J Sci Med Sport 1996;28:93-6.

55. Ruhl CE, Everhart JE. Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization: the NHANES I Epidemiologic Followup Study. First National Health and Nutrition Examination Survey. Ann Epidemiol 1999;9:424-35.

Copyright © 2019 Healthnotes, Inc. All rights reserved. www.healthnotes.com

Learn more about Healthnotes, the company.

The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2019.