Feature Archive

Heartburn Relief: New Medications Help

Prescriptions Let the Esophagus Heal

By Jeanie Lerche Davis
WebMD Feature

Reviewed By Charlotte Grayson

How do you spell relief? If you have a serious heartburn problem, a medication called a proton pump inhibitor (PPI) can significantly reduce stomach acid. You've heard the names: Nexium, Prilosec, Prevacid, Aciphex, and Protonix. And now they're even easier to use. Prilosec became available over the counter at your drug store in June 2003.

"They're extremely effective -- excellent medications for treating this problem," says William C. Orr, PhD, president of Lynn Health Sciences Institute in Oklahoma City, a clinical professor of medicine, and a specialist in gastrointestinal disorders at the University of Oklahoma Health Sciences Center.

However, you won't get immediate relief from these heartburn medications. "They may take up to five days to become effective," he says. And they can't be used by people with a history of kidney or liver problems.

Just keep in mind, "the PPI medications have only been available from 12 to 15 years -- and that was mainly in Europe -- so we don't have any data on the long-term effects," says Radhika Srinivasan, MD, a gastrointestinal specialist and assistant professor of medicine at the University of Pennsylvania in Philadelphia.

"These are safe medications, but we just don't know," she tells WebMD. "That's why it's important to discuss these things with your doctor."

Early animal studies had suggested that use of PPIs over a period of several years was associated with an increase in stomach cancer. However, that was not the case in later studies in humans.

For people with mild or occasional heartburn, over-the-counter (OTC) antacids -- like Gaviscon, Mylanta, Maalox, Tums, Rolaids -- are fine, and work to neutralize some of the stomach acid. Zantac, Tagamet, and Pepcid are acid reducers, and provide longer relief than the antacids.

But if you're taking milder OTC medications several times a week, it's best to see your doctor, Srinivasan says. "You may need prescription medication -- something you take every day, to help the esophagus heal. Or you may need higher doses of medications that you cannot get over the counter. Also, if you've had symptoms for a long time -- over five years -- you may need to look at other options [such as surgery]. There is no cookbook approach to this."

Your heartburn might also trigger an asthma attack -- which not all asthmatics realize, she adds. "Reflux acid coming into the esophagus can trigger constriction of bronchial tubes, which triggers an asthma attack."

Medically Updated July 15, 2003

Published October 22, 2002

©1996-2005 WebMD Inc. All rights reserved.
Last Editorial Review: 1/31/2005 5:54:56 AM

    Health Solutions From Our Sponsors