For many of my patients, this summer has offered the chance to finally reconnect with family and friends after more than a year apart due to the COVID-19 pandemic. We’re all eager to soak up the familiar rituals of summer: long-awaited vacations, cookouts and picnics in the park, and other fun with family. It’s also a time when many of us enjoy some of the season’s unique foods and drinks, which aren’t always the healthiest (spicy barbeque, salsa, fries, funnel cakes, summer cocktails and… beer, anyone?). As much as we all love some summertime indulgences, our bodies don’t always love the potential consequences—such as heartburn.
Signs of Heartburn
More than 1 in 4 adults experience heartburn at least once a week. If you’re in this camp, you know that heartburn can be a miserable experience: the burning sensation in your chest or throat starts just after finishing a meal and can last for hours afterwards. Sometimes heart issues can mimic heartburn, so it is important to seek medical care for chest discomfort that you suspect may be heart-related, or for heartburn symptoms that persist despite taking antacids.
Managing Your Heartburn Symptoms
1. Think about lifestyle changes you can make
Lifestyle considerations, like maintaining a healthy weight, not smoking and diet modification, are an important first step in helping to manage heartburn symptoms. Further treatment for heartburn symptoms can be confusing because there are so many options available—in the forms of both over-the-counter (OTC) and prescription (Rx) medicines. No matter how your heartburn symptoms manifest, there are unique solutions to help you treat them.
2. Find the heartburn medicine that’s right for you
- If you’re struggling with heartburn occasionally, antacids (such as Alka-Seltzer®, Mylanta® or TUMS®) can be helpful in addition to lifestyle changes.
- If heartburn symptoms persist despite taking antacids, you may consider trying OTC H2 blockers such as famotidine (PEPCID®, Zantac 360°TM) or cimetidine (Tagamet®).
- If you are still suffering from heartburn two or more days a week, this is considered “frequent heartburn,” which may require a different treatment approach for relief. Many of my patients experiencing frequent heartburn often seek relief in the OTC aisle of the drug store—specifically to look for OTC proton pump inhibitors (PPIs), which help relieve heartburn symptoms by blocking special “pumps” that produce acid.
What you should know about PPIs
PPIs come in both Rx and OTC form, and OTC PPIs are the only OTC medicine indicated to treat symptoms of frequent heartburn. You might recognize them by their brand names, such as Nexium®24HR, Prevacid®24HR, Prilosec OTC®, Zegrid OTC®, or store brands of generics such as omeprazole, lansoprazole or esomeprazole. PPIs work by decreasing the amount of acid in your stomach.
The instructions for OTC PPIs are different compared to those for Rx PPIs, and it’s an important distinction that some patients don’t always know. Rx PPIs are used to treat more serious cases like chronic heartburn, gastroesophageal reflux disease (GERD) and a number of other gastrointestinal conditions. They are also prescribed at higher doses than OTC forms and are used for longer periods of time—but should only be taken under medical supervision.
PPIs are safe and effective when used as directed, but it is very important to seek professional medical care if your symptoms require taking PPIs more frequently than the labeling instructs, to ensure that the proper diagnosis is made and treatment is taken for your condition. While recent studies have shown a number of adverse effects associated with PPIs, it is important to note that an international clinical trial was published in June 2019 confirming the safety of PPIs when taken as directed.
Where to go for more information
Given how common heartburn is and the many treatment options available, it’s no wonder patients can be confused. Heartburn is one of the most common reasons people visit their healthcare provider, as well as one of the most common conditions discussed with pharmacists. The CHPA Educational Foundation’s digestive health resources are a good place to begin learning about heartburn. But it’s also helpful to talk with your healthcare provider or pharmacist to find the right treatment option for you, so you—and your digestive system—can enjoy all that summer has to offer.
 Michael Camilleri et al., “Prevalence and Socioeconomic Impact of Upper Gastrointestinal Disorders in the United States: Results of the US Upper Gastrointestinal Study.” Clinical Gastroenterology and Hepatology 3, no. 6 (June 2005): 543–552, https://doi.org/10.1016/S1542-3565(05)00153-9.
 “Acid Reflux: Overview,” American College of Gastroenterology, accessed April 16, 2019, https://gi.org/topics/acid-reflux/.
 Paul Moayyedi et al., “Safety of Proton Pump Inhibitors Based on a Large, Multi-year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin.” Gastroenterology (May 2019): https://doi.org/10.1053/j.gastro.2019.05.056.