Heartburn and GERD

What is it? Who is affected? What are the symptoms? What can I do to prevent and treat it?

Effective OTC medications Important additional information Examples of OTC medications

What is It?

Heartburn is a painful, burning sensation in the chest and is often accompanied with a bitter taste in the throat.

Heartburn that occurs more than twice a week may be considered symptomatic of gastroesophageal reflux disease (GERD). GERD occurs when the lower esophageal sphincter does not close properly and allows the stomach contents to splash back (reflux) into the esophagus. Stomach acid irritates the lining of the esophagus and causes heartburn.

GERD can be a major disruption to one's quality of life¹.

Who is affected?

Eighteen million American adults take medicine for indigestion relief at least twice a week.

Approximately 3 to 7 percent of the American population suffers from GERD²,³.

What are the symptoms?

Symptoms of GERD include:

• Persistent heartburn (a main symptom; however, GERD can exist without heartburn)
• Acid regurgitation (a main symptom)
• Pain in the chest
• Hoarseness in the morning
• Trouble swallowing or tightness in the throat
• Dry cough
• Bad breath
• It can also feel like you are choking or have food stuck in your throat

What can I do to prevent and treat it?

Helpful tips to avoid heartburn:

• Monitor your intake of trigger foods such as citrus fruits, tomato products, peppermint, and fatty foods.
• Cut back on cigarettes, coffee, and alcohol.
• Elevate the head of your bed.
• Avoid wearing tight clothing that constricts your abdomen.
• Lose weight if you are overweight.
• Eat small meals to avoid pressure on the stomach.
• Don't lie down or exercise immediately after a meal.

OTC medications can be used to treat symptoms

OTC medications have been shown to be effective for people with mild to moderate GERD in¹:

• Preventing symptoms
• Rapidly relieving symptoms
• Reducing the frequency and severity of symptoms

Recently, an American Gastroenterological Association panel recommended OTC medications first for heartburn patients with typical GERD symptoms that have been occurring for less than four weeks¹.

There are several different types of drugs for treating GERD:

• Foaming agents prevent reflux by coating the stomach contents.
• Antacids can relieve heartburn and other mild symptoms
  • There are many antacids on the market and some even include the added benefit of calcium. Products that combine aluminum and magnesium salts balance the gastrointestinal side effects caused by antacids, which can include diarrhea or constipation.
  .
• H₂ blockers slow acid production.
  • These drugs provide short-term relief and are effective for about half of those who have GERD symptoms.
  • The American Gastroenterological Association panel specifically found that combination H2 blockers and antacids were more effective than either antacids or H₂ blockers alone¹. The combination provides quick symptom relief of antacids with the sustained duration of H₂ blockers⁴.
• Proton pump inhibitors slow acid production.
  • Omeprazole (Prilosec OTC) is now available as an over-the-counter drug.
  • Omeprazole may relieve stomach acid symptoms a little slower than other acid-lowering drugs. Its full effect may take 1-4 days.
  • Omeprazole is useful for people who have frequent heartburn, 2 or more times a week. It is recommended that Prilosec OTC be taken once daily for at least 14 days⁵.

Important additional information

Consult your physician before taking an OTC to treat heartburn if you are currently taking any prescription drugs.

If symptoms persist for periods of greater than four weeks despite the use of OTC medications, please see your physician for an evaluation⁴.

See your physician immediately if you have any of the following symptoms as they may signal potential GERD complications⁴:

• bleeding
• weight loss
• choking
• chest pain
• stomach pain

The following are examples of OTC medications can be used to treat symptoms of heartburn or GERD:

Symptom relief	Helpful medications	Active ingredients* to look for in generic and name brand OTC products
Relieve upset stomach, heartburn, acid indigestion, and sour stomach	Foaming Agents	Aluminum Hydroxide Magnesium Trisilicate Example: Gaviscon®
	Antacid	Calcium Carbonate Example: Tums®
		Aluminum Hydroxide and Magnesium Hydroxide Example: Maalox®
		Sodium Citrate Example: Alka Seltzer®
	H2 Blocker	Cimetidine Example: Tagamet HB®
		Famotidine Example: Pepcid AC®, Maximum Strength Pepcid AC®, Pepcid Complete®
		Ranitidine Example: Zantac 75®, Maximum Strength Zantac 150TM
		Nizatidine Example: Axid AR®
	Proton Pump Inhibitor	Omeprazole Example: Prilosec OTC™

* Active ingredients: ingredients in a medication that produce a therapeutic response

---

Sources:

¹ American Gastroenterological Association – Expert Panel Reaches Consensus on GERD Management Strategies.
² National Digestive Disease Clearinghouse
³ The Gallup Organization. A Gallup organization National Survey: HB Across America, Princeton. 1988 and 2000.
⁴ Walter L. Peterson, MD. Improving the Management of GERD - Evidence-based Therapeutic Strategies.
⁵ Prilosec OTC package insert, 2003.

Note: This information is intended to provide readers with health information. The information provided is not a substitute for consultation with a healthcare provider. Brand names included on this Web page are provided for examples only. Their inclusion does not mean that they are endorsed by Blue Cross and Blue Shield of North Carolina.