There have been recent news reports that the over-the-counter heartburn drug, Zantac (ranitidine), contains trace amounts of a carcinogen, NDMA. That sounds scary, but the drug HAS NOT been recalled, and patients are not being told to stop taking it. The Food and Drug Administration (FDA) is working to figure out why NDMA is present in ranitidine, and whether or not it’s a health risk.
In the meantime, I’m reposting this information about treating heartburn. If you take OTC Zantac or generic ranitidine, consider one of the other H2 blockers I have listed below. FN
The other day a family member asked for my advice on treating heartburn. It’s a common problem and fortunately there are many lifestyle changes and simple products to try before spending money on doctors’ appointments and prescription medications.
For the occasional case of heartburn following a large meal, or eating too late at night, or being more stressed than usual, try a herbal product or one of the inexpensive over-the-counter antacids.
- Chamomile has a mild healing and protective effect on the digestive tract. Choose a good-quality tea bag and enjoy a cup after a meal.
- Peppermint also has a mild effect in aiding digestion. Again, choose a good quality tea bag and drink a cup after a meal. An alternative would be to suck on a peppermint lozenge, like Altoids. Don’t OD on them, though. Too much peppermint can be irritating to your stomach.
- Fennel is commonly used as a digestive aid in Indian restaurants, and fennel seeds can be found in most grocery stores. Chew on a teaspoonful after a spicy meal.
- Ginger is typically used to treat nausea, but it’s also helpful for indigestion. Chew on a quarter-sized round of fresh ginger or, if that’s too strong a taste, pour boiling water over a tablespoon of minced fresh ginger and brew a tea. Strain before drinking.
Herbal effects are usually pretty mild, but I always suggest starting with the least expensive, least harmful products. If one of these doesn’t work for you, try an over-the-counter antacid.
Antacids work immediately, and are available as a liquid or chewable tablets. Liquids work more quickly than chewable tablets. The most common antacids brands are:
- Alka-Seltzer (sodium bicarbonate)
- Pepto-Bismol (bismuth subsalicylate, which is related to aspirin so anyone allergic to aspirin should NOT use Pepto-Bismol; prolonged use can turn your tongue and poop black!)
- Tums (calcium carbonate)
- Mylanta, Rolaids (calcium carbonate and magnesium hydroxide; prolonged use of magnesium can cause diarrhea)
- Gaviscon (aluminum hydroxide and magnesium hydroxide; prolonged use of aluminum can cause constipation)
All of these products are also available as cheaper store brands. Read the labels! Know what you are buying, and find out which product works best for you.
Treating the symptoms is fine for the short term, but anyone who experiences heartburn frequently needs to consider some simple lifestyle changes.
- Avoid big meals. Drink a glass of water or herbal tea before a meal and eat smaller portions. Wait 10-20 minutes to see if you’re still hungry.
- Avoid foods or beverages that trigger heartburn for you. Pay attention to what foods cause you problems and then limit or avoid them. Common heartburn triggers are fatty foods, caffeine, alcohol, sodas, garlic, onion, cinnamon, peppermint (the oil, not the leaf), and acidic foods like fruit juices, citrus fruits and tomato products.
- Don’t eat within two hours of going to bed. If you lie down with a full stomach, you’re much more likely to experience heartburn. Also, raise the head of your bed about 6 inches by putting wood blocks under the frame.
- Lose weight. Abdominal fat puts a lot more pressure on your stomach, which then pushes the acid back up your esophagus.
- Quit smoking. Smoking interferes with your digestive system.
Related post: Home remedies for gas and bloating
Talk to your doctor before using other medications
If you’ve tried lifestyle changes and simple home remedies for heartburn and are still having problems, make an appointment with your doctor.
There are other types of heartburn medications available over-the-counter, but it’s best to consult with your doctor first. You don’t want to waste money buying a product that might not be the best for your problem.
Also, even though these medications are easily available, some are very expensive and can be harmful if not used as directed. Or they may interfere with other drugs you are taking. Talk to your doctor first.
The two commonly prescribed types of heartburn or GERD (gastroesophageal reflux disease) medications are:
- H2 blockers such as Pepcid (famotidine), Tagamet (cimetidine) and Zantac (ranitidine).
- Proton pump inhibitors (PPIs) such as Prevacid (lansoprazole), Nexium (esomeprazole), and Prilosec (omeprazole). Prolonged use of PPIs has been linked to both an increased risk of heart attack and dementia.
These drugs are tablets that are taken before and after meals to reduce stomach acid, but they don’t work immediately. It could be several days before you notice any relief, and you might need to use a quick-acting antacid as well.
If your physician recommends an H2 blocker or a PPI, buying them at the drugstore might be cheaper than getting a prescription, but not always. It depends on your health insurance plan, so do the math first. I talk about this in my post Nexium—Brand, generic, prescription or OTC?
The good news about heartburn and GERD is that there are many treatments available. But try the simplest and least expensive home remedies first. And if you do use a stronger medication, use the lowest effective dose for the shortest time possible.
That’s good advice for any drug!
For more information on home remedies, here are my go-to books:
This post has been updated since its original publication in 2018.