Timing Matters for Some Heartburn Medication
A bowl of spicy chili, a cup of coffee, some deep-fried onion rings—these foods may be tasty. But they can also cause heartburn. When this discomfort hits you a few times a week or more, you may have gastroesophageal reflux disease (GERD).
Drugs called proton pump inhibitors (PPIs) can help relieve GERD symptoms. But are you taking that pill correctly? A recent survey shows that not all GERD sufferers are.
When you have GERD, stomach contents flow back up into your esophagus—the tube that connects your mouth to your stomach. The esophagus has a small valve that normally keeps stomach contents where they belong. Sometimes this valve can weaken, though. That may cause:
Frequent heartburn, especially after meals
Sour taste in the mouth
Nausea and vomiting
Dry, persistent cough
PPIs are one of the best treatment choices for GERD. These drugs include the brand names Prilosec and Nexium. How do they work? PPIs block an enzyme called H-K-ATPase. This enzyme is essential in making stomach acid.
Unlike other heartburn medication, PPIs shouldn’t be taken when you first feel symptoms. They work best when taken 30 minutes before breakfast or your first meal of the day. They react to the surge in stomach acid after you eat.
A recent survey of more than 1,900 adults found that many GERD sufferers don’t take PPIs this way. Only 2 in 5 people who bought the drug from a store reported taking it correctly. Those who were prescribed the drug did better. They were 2 to 3 times more likely to take it as directed. Overall, using the drug correctly made symptoms happen less often. Symptoms were also less severe.
Many GERD sufferers take a PPI every day. The drug is considered a safe treatment choice. But using for a long time may have risks. For instance, some research has linked this medicine to hip and wrist fractures. Other studies suggest PPIs may raise a person’s risk for anemia, pneumonia, or other infections.
Your best strategy: Talk with your doctor about your PPI use. You may want to develop a plan to cut down gradually on the medication. That’s especially true if you are at risk for fractures or other health problems.
You may be able to also keep GERD under control by:
Avoiding foods that trigger your symptoms. These may include chocolate, coffee, and peppermint. You may also want to stay away from food that is greasy, spicy, or fried.
Losing weight, if needed. People who are overweight or obese are more likely to have GERD. So are those who smoke.
Eating at least 2 hours before bedtime. Lying down right after you eat can cause symptoms.
Elevating the head of your bed by 6 to 8 inches. Place wooden blocks under the bed frame.
Learn more about GERD, its causes, and other treatment options.
March 21, 2017
Consumer Use of Over-the-Counter Proton Pump Inhibitors in Patients with Gastroesophageal Reflux Disease. Sheikh I, et al. American Journal of Gastroenterology. 2014;109(6):789-94., Gastroesophageal Reflux Disease in Adults. 2012. First Consult. 2012., Overview and Comparison of the Proton Pump Inhibitors for the Treatment of Acid-Related Disorders. M. Wolfe. 2104. UpToDate., Reducing Adverse Effects of Proton Pump Inhibitors. PW Ament, DB Dicola, ME James. American Family Physician. 2012;86(1):66-70., Reported Side Effects and Complications of Long-Term Proton Pump Inhibitor Use: Dissecting the Evidence. D Johnson, E Oldfield. Clinical Gastroenterology and Hepatology. 2013;11(5):458-64., Systematic Review: Patterns of Proton Pump Inhibitor Use and Adherence in Gastroesophageal Reflux Disease. Hungin AP, et al. Clinical Gastroenterology and Hepatology. 2012;10(2):109-16.
Turley, Ray, BSN, MSN