What do you recommend to patients that can help alleviate heartburn and reflux?
“I tell patients to avoid foods that can precipitate heartburn,” says Peikin. These are foods that can relax the little valve at the end of the esophagus that tries to prevent the acid from coming up. The foods that tend to do that are peppermint, chocolate, nuts, caffeine and greasy foods. Carbonated beverages may cause a lot of gas, which causes belching and brings the fluid back up with it.
Also, a lot of reflux occurs at nighttime. When you're lying down, it's easier for stomach contents to travel backwards into the esophagus. So elevating your head at night in bed can help prevent reflux. “I advise patients not to eat for three or four hours before lying down,” says Peikin, “because eating food causes a surge in acid secretion.”
Since most people who have heartburn don't have serious complications, it's perfectly reasonable to self-medicate with over-the-counter remedies available at the drugstore.
With these lifestyle changes and an occasional antacid or H2 blocker, some people will find relief. But other people are going to need prescription medication. The options are prescription strength H2 blockers, or more commonly, the proton pump inhibitor class of drugs, which are very potent and very effective in treating reflux.
How do antacids work to fight heartburn?
Antacids neutralize acid in the stomach so that when the fluid from the stomach comes back up into the esophagus, it's less acidic. The benefit of an antacid is that it works immediately. You don't have to wait for it to be absorbed by the body. The bad news is that it doesn't last that long and you may end up having recurrent heartburn and need to take antacids more frequently.
