If you’ve experienced heartburn, you may be familiar with the discomfort it causes — often a burning pain in your lower chest. What you may not know is that certain heartburn medications called proton pump inhibitors (PPIs) are usually not needed when other less-powerful drugs can provide relief.
Heartburn is caused by stomach acid that backs up into the throat. PPIs treat heartburn by keeping the stomach from producing too much acid. However, PPIs are powerful drugs, and studies show that more than half of people who take PPIs probably don’t need them.
Do you need a PPI to treat your heartburn?
“People who get the occasional heartburn — after a big, spicy meal, for example — will experience discomfort, although this type of heartburn is not serious,” says Dr. David Hall, a double board-certified internal medicine and pediatrics doctor with Sharp Rees-Stealy Medical Group. “In cases like these, antacid medication will often provide needed relief.”
Dr. Hall adds that if you experience heartburn more than twice a week for several weeks, it’s important to have your symptoms evaluated by your doctor.
“Recurring heartburn can be a sign of gastroesophageal reflux disease, or GERD,” he says. “Since GERD can cause damage to the lining of your esophagus over time, doctors will often initially prescribe a PPI treatment. However, for long term-management of GERD, identifying and removing triggers through lifestyle modification is extremely important.”
If you need to take a PPI, Dr. Hall suggests talking to your doctor about taking the lowest dose for the shortest amount of time possible.
“Taking a PPI at a low dosage for less than a year is generally safe, but taking PPIs for a year or longer is associated with increased risk of hip fractures, pneumonia and magnesium deficiency in the blood, which can cause trembling, muscle cramps and irregular heartbeats,” he says. “Long-term use has also been linked to Clostridium difficile, a serious intestinal infection that can cause severe diarrhea, fever and, in rare cases, death.”
Lifestyle tips to reduce heartburn
Many people are able to ease the symptoms of heartburn without drugs through simple changes in their diet and lifestyle. Dr. Hall suggests the following tips before trying medications:
- Avoid certain foods and beverages.
Try to determine which items may be causing your heartburn. These may include alcohol, citrus, peppermint, fried or spicy foods, coffee or other caffeinated drinks, or foods with a lot of tomatoes.
- Don’t eat large meals, especially before bedtime.
Eat small portions during mealtime, and avoid lying down for two hours after you eat.
- If you smoke, quit.
Research shows that smoking raises your risk for heartburn and GERD.
- Lose extra weight.
Shedding a few extra pounds can help reduce the effects of heartburn and GERD.
- Loosen up.
Avoid tight clothes or belts that put pressure on your stomach.
- Sleep with your head raised.
You can elevate your upper body with pillows, or raise the head of your bed about six to eight inches.
At Sharp Rees-Stealy, we want to empower you to make well-informed choices about your treatment options. That’s why we’ve made it our priority to support our doctors in helping you make smart and effective decisions by participating in Choosing Wisely®.
Choosing Wisely, an initiative of the ABIM Foundation, educates patients and doctors on selecting the most effective treatment available and avoiding unproductive, costly procedures. Sharp Rees-Stealy is the only medical group in Southern California to participate in this national campaign.