When Your Heartburn Outlasts Your Medication

Many different types of medications can be used to treat heartburn. But what works for one person may not work for another, so you may have to experiment until you find what's best for you.

If you constantly take over-the-counter antacids but your heartburn symptoms persist or if your prescription heartburn medication doesn't provide much relief, your doctor may suggest a different type of medicine, or even a combination of drugs, that work in different ways to help control your symptoms. If your symptoms occur frequently, and become severe, you may need long-term drug therapy.

Gastroesophageal reflux disease (GERD) is a chronic and more serious form of heartburn that can lead to significant health problems. If you only occasionally suffer symptoms of acid reflux, you probably don't have GERD. But the drug treatment may be similar. In both cases, it's important to be consistent about taking whatever type of medication your doctor recommends or prescribes to help prevent your condition from getting worse.

The various types of medications used to treat heartburn and GERD come in different forms and work in various ways. All these medications can cause side effects or become ineffective, in which case, you should speak to your doctor immediately to come up with an alternative treatment plan.

  • Antacids, such as calcium carbonate, quickly neutralize stomach acid. They are available without a prescription in pill or liquid form.
  • Histamine type 2 receptor antagonists (H2RAs), such as famotidine and cimetidine, reduce stomach acid production, which reduces your risk of heartburn. They are available over the counter or by prescription in pill form.
  • Protein pump inhibitors (PPIs), such as dexlansoprazole and omeprazole, also reduce the production of stomach acid and are also available over the counter and by prescription in pill form.

Anti-reflux surgery, known as fundoplication, is sometimes considered for severe cases of GERD. The surgery involves wrapping the upper part of the stomach around the lower part of the esophagus to compensate for a faulty sphincter. The procedure may improve symptoms of GERD but generally does not eliminate the need for medication. This type of surgery also carries a higher risk of side effects than drug therapy.

A newer form of surgery, known as laparoscopic fundoplication, may be more effective at controlling symptoms, but experts are not sure if surgery is more effective than medication at preventing possible long-term complications of GERD, including cancer of the lining of the esophagus.

Sources:

National Institute of Diabetes and Digestive and Kidney Diseases: Heartburn, Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD) NIH Publication No. l 07-0882 May 2007 Web May 2012
http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/#6

U.S. Department of Health & Human Services: Management Strategies for Gastroesophageal Reflux Disease: An Update: Executive Summary No. 29; AHRQ pub. No. 11- EHCO49-1 Sept 2011 Web May 2012
http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=781&pageaction=displayproduct