Using Over-the-Counter Medici... Video Transcript

Participants

Hashem B. El-Serag MD, MPH, A. Mark Fendrick MD, Evelyn Hermes-DeS PharmD, John R. Horn PharmD, FC

Summary

Many people complain of heartburn. But in most cases, it's remarkably easy to find relief. Listen to experts explain why getting rid of heartburn may be simpler than you think.

Webcast Transcript

A. MARK FENDRICK, MD: I think that if you talk to anybody on the street and ask them if they've had any symptoms of a rising, burning feeling or acid in their stomach, that you'd be surprised, and I would guess it to be in the tens of millions of people.

ANNOUNCER: Heartburn is a common problem in the US. Its cause is simple. Acid in the stomach doesn't stay were its supposed to.

A. MARK FENDRICK, MD: Acid is made by the stomach. And most of the time, the acid remains in the stomach. Sometimes, a bit of the acid will back up, or reflux, into the esophagus, which is the food tube which connects the mouth to the stomach. So when this acid from the stomach gets into the esophagus, the symptom of heartburn is frequently experienced.

ANNOUNCER: When heartburn is accompanied by certain red flags, it ought to be evaluated by a doctor.

JOHN HORN, PharmD: Heartburn can be a sign of a more severe condition that might require a physician's evaluation when a number of symptoms or signs are present. For example, if a patient has painful or difficult swallowing, if they have GI blood loss, whether that's in the stool or perhaps vomiting blood. Sometimes patients develop coughs or upper respiratory symptoms associated with their heartburn. Severe chest pain ought to be evaluated by a physician. So there's a number of kind of warning signs or alarm signs.

ANNOUNCER: But when a person has none of these alarm symptoms, doctors say patients can feel comfortable treating their heartburn themselves.

Simple lifestyle changes are often a good place to start: avoiding acidic foods, cutting alcohol consumption, quitting smoking, losing weight, waiting a few hours after eating before lying down to bed. But when lifestyle changes are not enough, people with heartburn can usually get good relief with readily-available over-the-counter medicines, although a little trial and error may be in order.

JOHN HORN, PharmD: I think a lot of patients get good relief from over-the-counter medicines. They may find that they may have to try different medicines or combinations or different doses or combine them with some lifestyle changes, but, if a patient works at it, they can usually get pretty good relief from a simple episodic heartburn.

EVELYN HERMES DeSANTIS, PharmD: For treating simple heartburn, we have a number of different medications available. The over-the-counter products that have been on the market for some time include the antacids and the histamine blockers, the H2RAs, as they're known as. In addition to that, we also now have a proton pump inhibitor over-the-counter. So those are really the three main classes of drugs that have been used for the treatment of heartburn.

JOHN HORN, PharmD: Antacids really are the best treatment for an acute episode of heartburn. So if one has had a big dinner and at 10:00 at night they develop heartburn or two in the afternoon after lunch they get heartburn, the treatment for that episode of heartburn is an antacid.

A. MARK FENDRICK, MD: Antacids work by neutralizing the acid that already exists in the stomach. So these drugs work very quickly and will eliminate this excess acid.

JOHN HORN, PharmD: Their limitation is that they don't last very long, so that when you take an antacid you can treat the episode of heartburn that you're having right now, but it's not going to do much to prevent an episode happening later in the day or tomorrow.

ANNOUNCER: Rather than neutralize acid that already exists, another approach toward heartburn is to reduce acid production with an acid blocker, for longer-term relief.

JOHN HORN, PharmD: There's a cell in the stomach called a parietal cell, and that parietal cell makes acid.