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Nothing Is Helping My Heartburn

Reasons Why Your Heartburn Medicine Isn’t Working

Heartburn treatment – Patient Testimonial

Perhaps you’ve been misdiagnosed. Perhaps your diet is exacerbating your symptoms. Find out why heartburn meds can let you down, and what to do about it.

If you have horrible, persistent heartburn, relief can be as simple as popping a pill once or twice a day. Proton pump inhibitors, or PPIs, put the kibosh on the stomachs acid production, keeping gastric juice from backing up into the esophagus and causing pain.

But they dont work for everyone. Even if youre one of those people who does well on PPIs you can still have breakthrough symptoms from time to time, when heartburn flares into an agonizing episode.

RELATED: 9 Things That Could Be Giving You Acid Reflux

Studies suggest that up to 40% of people with heartburn who take a PPI once a day still experience heartburn or other breakthrough symptoms once in a while, says David A. Johnson, MD, a professor of medicine and the chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Va., and past president of the American College of Gastroenterology.

Find out why heartburn meds can let you downand what to do about it.

Beat The Burn Heartburn That Is

At least 40 million Americans suffer from heartburn. Most have only mild or occasional symptoms. However, about 15 million need medication on a daily basis to control that burning sensation.

What is heartburn?

The feeling varies from person to person, but most people complain about a burning sensation in the chest, near the level of the heart. Occasionally, the pain is lower, near the bottom of the breastbone or sternum. Real heartburn has nothing to do with the heart, but the location of the pain often requires that we make sure the heart is not involved.

The accepted medical term for the problem that causes heartburn is gastroesophageal reflux disease . Its also commonly referred to as acid reflux.

What causes heartburn?

Quite simply, acid reflux refers to acid from the stomach flowing backwards up into the esophagus, also known as the swallowing tube.

As most people know, the stomach makes acid to help digest our food. The lining of the stomach is built to withstand the effects of acid. The acid is supposed to travel downstream into the small intestine along with the food being digested and absorbed. Therefore, the first part of the small intestine, known as the duodenum, also handles acid quite well.

What are symptoms of heartburn?

Are there long-term risks?

In the end result, the main question is, When should I see my doctor?

Topics in this Post

Questions To Ask Your Doctor

  • Whats causing my indigestion?
  • What are some foods I should avoid to help with my indigestion?
  • How much time do I need to leave been my final meal of the day and bedtime?
  • Does sleeping on an elevated pillow help indigestion?
  • What medicines will help my indigestion? Do they have side effects?
  • Are there any medicines I should avoid that may make my indigestion worse?
  • What should I do when nothing seems to help my indigestion?

Recommended Reading: What To Eat To Get Rid Of Heartburn Fast

What Is The Quickest Way To Get Rid Of Heartburn

Taking antacids is considered the quickest way to get rid of heartburn. These over-the-counter medications help neutralize stomach acid. They are one of the first recommended treatments. They may provide quick relief. However, antacid overuse can cause problems such as diarrhea or chronic kidney disease, especially if they contain aluminum and magnesium.

Other common ways to get rid of heartburn include

  • H2 receptor blockers: These medications work to reduce the amount of acid that is made in the stomach. While they do not work as quickly as antacids, they provide longer relief for up to 12 hours. Examples of these include Pepcid AC, Tagamet HB, Zantac and Axid AR. Although most people have no problems taking them, long-term use can cause vitamin B12 deficiency leading to an increased risk of bone fractures.
  • Proton pump inhibitors: This class of medications block acid production. They also help to heal any damage caused to the lining of the esophagus. They are much stronger than the H2 receptor blockers and include Prevacid, Prilosec, Protonix and Zegerid. Excessive use of these medications can cause diarrhea and nausea, vitamin B12 deficiency and an increased risk of bone fractures.
  • Baclofen: This medication works to strengthen the muscular valve present at the lower esophageal sphincter muscle. However, it may cause nausea and fatigue in some people.
  • Surgical procedures: In rare cases, these are required to help with severe heartburn symptoms.

Disproving The Stomach Acid Theory

Heartburn: Trigger Foods to Avoid + 6 Natural Ways to Get Rid of It

When you look at the data, blaming GERD on too much stomach acid doesnt make sense. Stomach acid actually tends to decline, not rise, with age, while GERD risk increases with age. In fact, 40-year-olds, on average, generate about half as much as stomach acid as 20-year-olds do. And, according to one study, over 40 percent of people age 80 and up may be producing almost no stomach acid at all. Whats more, my patients with heartburn and GERD have responded very well to HCl supplementation, which actually increases their stomach acid. Thats the opposite of what we would expect if excess stomach acid were to blame for the problem.

You need adequate stomach acid to kill opportunistic pathogens, help properly digest food, and maintain optimal health. Reduced stomach acid correlates with a wide range of health problems, and PPIs can easily exacerbate the condition.

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Antacids H2 Blockers Ppis Our Pharmacists Explain The Options

Fortunately, pharmacies stock plenty of safe, effective remedies so many, in fact, that it can be confusing trying to figure out which one is right for you. So, we asked some pharmacists for help. Heres a rundown on the three classes of heartburn remedies, courtesy of The Portland Clinic pharmacy team.

Antacids

Antacids such as Tums, Rolaids, Maalox and Mylanta are the fastest-acting heartburn relievers. They take effect in less than five minutes by quickly neutralizing acid in the stomach. For mild heartburn after a meal, antacids offer quick relief that lasts about 20-30 minutes. They come in a variety of strengths, so check labels for dosing information. In general, you shouldnt use antacids more than four times a day. If you find yourself reaching for them frequently, it might be time to try a different one or to switch to one of the stronger remedies.

H2 blockers

Pepcid, Tagamet and Zantac are some of the more well-known H2 blockers, so called because they block a chemical called histamine that prompts the stomach to make acid. They take longer than antacids to bring relief about 30-45 minutes but the relief lasts 4-10 hours. H2 blockers can be used to relieve mild or moderate heartburn, or to prevent it when you anticipate heartburn . You also can combine H2 blockers with antacids for quicker relief. Just dont take H2 blockers more than twice a day, or for more than two weeks if you use them regularly.

Proton pump inhibitors

When Should You Go To An Er For Acid Reflux

Some people who experience acid reflux may think that other symptoms that might occur at the same time as reflux are simply part of the bodys reflux response. However, symptoms that go beyond regular heartburn are probably not just incidental and could be a sign of something more serious.

These symptoms accompanying acid reflux should always mean a trip to the emergency room:

  • Feeling confused or sudden weakness
  • When the reflux moves/relocates from how you typically experience it
  • Fainting/loss of consciousness, even briefly
  • Vomit that has blood in it or is black
  • Stool that is black and/or accompanied by blood

Also Check: What To Eat If You Have Heartburn

How Do I Treat Heartburn During Pregnancy

When youre growing a human being, you dont have time for that yucky acid reflux. But your usual go-to methods for treating it may not be safe for your unborn baby.

Instead, here are some of the safest and best ways to get rid of heartburn when youre pregnant:

  • Dip into some yogurt. Its probiotics and soothing texture make yogurt a great option for extinguishing heartburn or at least dousing the flames a little.
  • Drink milk with honey. According to the American Pregnancy Association, a tablespoon of honey mixed in a glass of warm milk may be just what you need to neutralize heartburn-causing acid.
  • Snack on almonds. Munching on a handful of almonds may provide heartburn relief since these nuts have a lower acidity level than others.
  • Eat pineapple or papaya. For some women, the digestive enzymes in pineapple and papaya have helped ease symptoms. Eating these fruits after your meals can aid digestion and reduce your chances of heartburn.
  • Try a little ginger. You probably knew ginger was a good remedy for an upset stomach. Well, that makes it a helpful candidate for fighting off heartburn, too. Among gingers many benefits, it can reduce inflammation and prevent stomach acid from traveling up the esophagus.
  • Chew sugar-free gum. Another effective method for taming the burn is to chew some sugar-free gum. One study found that chewing sugar-free gum for 30 minutes after a meal can reduce acid reflux.
  • Is Gerd Dangerous Or Life

    How I cured my pregnancy Acid Reflux !!!

    GERD isnt life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:

    • Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
    • Barrett’s esophagus: Barrett’s esophagus is a condition that develops in some people who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barretts esophagus is a risk factor for cancer of the esophagus.
    • Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barretts esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
    • Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.

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    What Is The Difference Between Regular Heartburn And Gerd

    Everyone has heartburn from time to time. Theres nothing unusual about that. Generally, taking an antacid helps. However, if youre popping Tums more than three times a week, its time to speak to your doctor.

    The technical definition of GERD is mild acid reflux that occurs twice a week or moderate to severe acid reflux that occurs once a week. When over-the-counter medicines dont make a dent in the horrible heartburn, you likely have GERD.

    Why Antacids And Ppi Medications Dont Always Work

    If youre wondering why your heartburn isnt responding to Tums or why your omeprazole isnt working, youre probably desperately looking for answers, and more importantly, results. Who typically falls into the GERD treatment gap? While doctors struggle to predict exactly who will be unresponsive to PPIs, there do seem to be some trends. Studies show that certain patients are more likely to be unresponsive to PPIs if they suffer from certain conditions:

  • Issues with indigestion 5
  • Atypical symptoms such as cough, chest pain, or sleep disturbances7
  • Non-erosive reflux disease 8
  • Patients who continue to suffer from nighttime acid reflux symptoms often wonder if surgery might help. Studies actually show that GERD surgery, such as laparoscopic fundoplication, is less effective for refractory GERD patients than for those patients who are responsive to PPI medications9. How can you get out of the gap? If your GERD is worsening with PPI or other reflux medications, youll want to look for an alternative treatment plan more on that in a moment.

    Read Also: How To Eat To Avoid Heartburn

    C Make All The Necessary Lifestyle Changes

    There are many things you can do besides maintaining a healthy BMI and following a GERD friendly diet. Here is a short list of recommendations you should consider:

    • Avoid alcohol
    • If you smoke, stop immediately
    • Leave at least 3 hours between your final meal and bedtime
    • Wear loose-fitting clothes
    • Drink plenty of water
    • Walk for 20 minutes after a major meal to aid digestion
    • Try eating 5 or 6 small meals daily

    For a more thorough list of recommendations, we recommend you read Acid Reflux Remedies Questions, Answers, Stages & Treatments.

    A Maintain A Healthy Body Weight

    How to get rid of heartburn

    Do you know your body mass index ? If not, start now by entering your weight and height into a BMI calculator to use the NIH calculator and find your current BMI.

    A healthy BMI is between 19 and 25, but anyone with a compromised LES should not be at the high end of normal. We recommend a BMI of 24 or less. Why is this important? We wrote a cornerstone article titled How is your excess weight destroying your LES , which we highly recommend you read if you have a BMI greater than 24.

    This excess weight does two things that will increase your GERD symptoms. First, it distends the stomach, pulling down on the LES and stretching it out. Over a long-term, this will reduce the effectiveness of the LES to act as an effective barrier between the stomach and the oesophagus.

    Second, it puts added pressure on the diaphragm, potentially pushing stomach content into the esophagus. Many research studies have proven that a reduction in BMI will reduce GERD symptoms. In an NIH published paper researchers concluded the following:

    In summary, our findings suggest that, beyond being overweight or obese, the risk of GERD symptoms rises progressively with increasing BMI, even among normal weight individuals. This appears true for all degrees of symptom severity and duration, as well as for nocturnal symptoms. Notably, weight loss was associated with a decreased risk of symptoms.

    Read Also: Will Drinking Milk Help My Heartburn

    How To Prevent Heartburn And Acid Reflux

    Here are some ways to prevent heartburn and acid reflux:

    I apologize in advance for this. What’s the #1 food to avoid when you’re suffering from heartburn? Chocolate. The sweet, decadent treat deals heartburn sufferers a double doozy. It is nearly all fat, and it contains caffeine. But don’t despair! May I make a suggestion? The “new age” chocolate bars still taste delicious, but are made with a significant boost of pure cocoa powder and less sugar. The bars are usually labeled with what percentage of the bar is pure cocoa. I wouldn’t go any higher than 60%, or else it tastes like tree bark. Naturally, there is a benefit to a higher cocoa concentrate. Cocoa has tons of antioxidants, and helps lower blood pressure! It might take some getting used to, but you will probably end up enjoying these “uber cocoa” bars very much. Especially when you’ll have a lot less heartburn!

    Lighten up on the caffeine. Even though most people rely on a little bump for their daily grind, caffeinated drinks such as coffee, tea, and cola may irritate an already inflamed esophagus. Caffeine also relaxes the sphincter muscle.

    Check your waistline. Compare your tummy to a tube of toothpaste. If you take the cap off and you squeeze the tube in the middle, something’s going to come out of the top, right? A roll of fat around the belly squeezes the stomach the same way a hand would, but what comes up is nasty stomach acid. Maybe it’s time to give your stomach a break?

    When To See A Healthcare Provider

    If heartburn becomes chronic, it can lead to respiratory problems, inflammation, and narrowing of the esophagus.

    If you have symptoms that include the following, you should contact your healthcare provider.

    • The heartburn wont go away.
    • You have serious wheezing.
    • The symptoms of heartburn are more frequent and severe.
    • You have consistent hoarseness.
    • There is unexpected weight loss.
    • You have been taking over-the-counter antacids for more than two weeks, and you still have heartburn symptoms.
    • Vomiting occurs because of heartburn.
    • Prescription medicine doesnt relieve heartburn.

    It is important to keep in contact with your healthcare provider

    about your symptoms and progress. They can help you with any questions and concerns related to your specific condition.

    Also Check: What To Eat To Cure Heartburn

    Be Careful What You Drink

    Alcohol, coffee, and whole milk can all lead to heartburn, as can peppermint tea. Sodas and carbonated drinks may relax the LES and make your stomach acid more acidic, increasing your risk of heartburn. Highly acidic citrus juices such as orange and grapefruit can also cause acid reflux and heartburn in some people.13

    How Low Stomach Acid Leads To Increased Iap And Gerd

    Heartburn, Acid Reflux, GERD-Mayo Clinic

    Stomach acid is part of the bodys innate immune system, the first line of defense against pathogens. Most bacteria cant survive the stomachs highly acidic environment. If you dont have enough stomach acid, many of the pathogens that would normally be destroyed may survive the stomach and make their way into the rest of the GI tract. This can lead to chronic gut infections, impaired digestion, and an increase in IAP and GERD.

    Stomach acid also helps your body absorb many macro- and micronutrients. HCl stimulates the release of pancreatic enzymes and bile into the small intestine to help metabolize carbohydrates and fats. Without enough acid, your body cant digest carbohydrates properly. Those undigested carbs are then fermented by bacteria in a process that generates excess hydrogen gas. Again, that excess gas increases IAP and contributes to GERD.

    Also Check: What Doctor To See For Heartburn

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