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How to hold the heartburn this holiday season

For many, the holidays can mean overindulgence in rich foods and alcohol at parties and events—followed by an upset stomach and a bout of heartburn. But before you turn to popular treatments lined up on pharmacy shelves—Nexium 24HR, Prevacid 24HR and Prilosec OTC—consider whether the fire in your belly is one-time flare-up or whether it’s an ongoing flame that happens several times a week.

If you have heartburn from overeating

The best, first option for most people is an inexpensive, fast-acting, over-the-counter antacid like Maalox, Mylanta, Rolaids, Tums, or their generic equivalents. Others might need something stronger if they know in advance they'll be consuming something that triggers heartburn. In that case, try an acid-reducing H2 blocker, such as famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75, Zantac 150). Those drugs help about half of people who suffer from predictable heartburn, and are available without a prescription as low-cost generics.

If you have heartburn a few times a week

If your heartburn occurs more than twice a week for several weeks, it's a good idea to see a doctor because you may have gastroesophageal reflux disease, or GERD. This is a serious condition that can cause damage to your esophagus if left untreated. The good news is that drugs called proton pump inhibitors, or PPIs—like Nexium 24HR, Prevacid 24HR and Prilosec OTC—can help keep GERD under control. They effectively reduce the amount of stomach acid produced, making the contents of your stomach less erosive to the lining of the esophagus.

But when taken over months or years, PPIs can have serious side effects which, although are uncommon, can be serious. This includes chronic diarrhea due to a bacterial infection that can lead to severe intestinal problems and, in rare cases, death. Long-term use can deplete magnesium levels, which can trigger muscle spasms, an irregular heartbeat, and convulsions. Some research suggests they also can deplete vitamin B12 levels. Other potential side effects include a higher risk of pneumonia and certain bone fractures, including breaks in the wrist, forearm, and spine. You don’t want to take one of those drugs unless a doctor has diagnosed you with GERD.

If you and your doctor decide a PPI is a good choice to treat your GERD, our Best Buy Drug report recommends two over-the-counter proton pump inhibitors as your best first option:

  • Generic omeprazole OTC
  • Generic lansoprazole OTC

Both of those are just as effective and safe as more-expensive brand-name PPIs.

When you should treat heartburn yourself and when to get help.

How to prevent heartburn in the first place

Instead of relying on medication to put out the flames, first try these simple steps that might keep your belly jolly this holiday season:

  • Cut back on caffeine and alcohol.
  • Eat smaller meals.
  • Eat fewer fatty foods.
  • Go easy on spicy foods.
  • If you smoke, quit.

There’s not much evidence to support most of those options, but they are good for you in general and may be helpful.

If your heartburn is still bothering you, try raising the head of your bed 6 to 8 inches. This may help reduce heartburn flare-ups while you’re asleep. Place wooden blocks under the bed legs so that your head is higher than your feet. One small study found this eased heartburn symptoms.

A long-range strategy is losing weight if you need to, which may give you another reason to hold back on second helpings during holiday feasts.

If those changes don’t bring relief, then it may be time to try one of the medications discussed above. But for a one-time holiday heartburn flare-up, don’t reflexively reach for a PPI. In most cases an antacid or an acid-reducing H2 blocker is all you need.

—Steve Mitchell


This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

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