Gastroesophageal Reflux Disease

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.