Dr. Tim: How to Handle Heartburn

Sept. 20, 2006 — -- Heartburn is a digestive problem that occurs when stomach acid comes into contact with the lining of the esophagus and causes irritation. Most people suffer from heartburn occasionally, usually after a meal.

Chronic heartburn can lead to more serious conditions, but everyday heartburn is often controllable. So for the conclusion of our heartburn series, here's a look at the methods for managing what can be a chronic condition.

Sometimes simple lifestyle changes, such as losing weight or avoiding certain foods, can help.

Obviously, if a given food makes your heartburn worse, you should consider avoiding it. Substances like caffeine, alcohol, chocolate, garlic and peppermint commonly cause heartburn. Fatty foods and fried foods are also common offenders.

In addition to avoiding certain foods, there is a laundry list of standard tips that doctors might give to patients with heartburn. Here are a few:

Those tips are all supposed to reduce the pressure on the stomach and to counteract the gravitational flow of the stomach acid if it backs up into the food pipe -- that acid would usually cause the heartburn.

Any or all of these small measures can help in some cases but are usually not enough for moderate to severe heartburn. So in many cases, doctors and patients turn to medications.

That raises the obvious question: Which heartburn medications are best?

There are three basic classes of heartburn medications: antacids, H2 blockers and proton pump inhibitors.

Antacids come in many forms and many brands. Liquid antacids act more quickly than tablets, and while both can help for occasional bouts of heartburn, they only neutralize existing acid; they do not prevent stomach acid from being secreted in the first place.

But the other classes of medicines do lessen stomach acid production. H2 blockers include drugs sold as Tagamet, Pepcid, Axid and Zantac.