Heartburn Or Gastroesophageal Reflux Disease (GERD)


Common Causes or Triggers of Heartburn
Eating a large, especially fatty meal
Tomato sauces (spaghetti & pizza)
Lying down after a meal
Chocolate, peppermint
Coffee and tea
Alcohol and carbonated beverages
Some muscle relaxers and blood pressure medicines
Excess weight

What can you do to treat heartburn?
Many women with infrequent heartburn can easily control symptoms with diet and lifestyle modifications and limited use of over the counter acid-blocking medicines.


Diet and Lifestyle Modifications
Eat more frequent, but smaller meals
Avoid: - fatty food, coffee & tea, chocolate, peppermint, alcohol, smoking, carbonated beverages.
Maintain a normal weight
Avoid eating 2-3 hrs before bedtime
Elevate the head of the bed 4-6 inches


Over-the-Counter (OTC)Medicines*
(liquid or tablets):
Tums®, Rolaids®, Mylanta®, Maalox®, Gaviscon®, and many others.
OTC Acid Blockers: Pepcid AC® , Tagamet HB® , Zantac AC® ., Prilosec OTC®
*Important Note: If you are pregnant or nursing a baby, seek the advice of a doctor before using OTC acid blockers.


Medications Requiring Prescription
Proton Pump Inhibitors: esomeprazole, Nexium®; or
lansoprazole, Prevacid®; or
pentaprazole, Protonix®; or
rabeprazole, Aciphex®;
Pro-motility Drugs: cisapride, Propulsid®
Prescription Strength Antacids: sucralfate, Carafate®
Prescription Strength H2 Blockers: cimetidine, Tagamet® , ranitidine, Zantac® , famotidine, Pepcid® , nizatadine, Axid®

Can longstanding GERD cause serious problems?
Yes. In severe cases, acid reflux may cause esophageal ulcers, strictures and a pre-cancerous disorder called Barrett’s esophagus. Recent studies show that chronic heartburn which is not effectively treated and resolved over several years, can greatly increase your risk of cancer of the esophagus.


What treatments for heartburn are safe during pregnancy?
During pregnancy, the medical treatment of reflux should be balanced to alleviate the mother’s symptoms of heartburn, while protecting the developing fetus.

Step 1: Modification of diet & lifestyle

Step 2: Antacids are probably safe. Sodium bicarbonate can cause a condition known as metabolic acidosis and should be avoided during pregnancy. Magnesium containing antacids may interfere with uterine contractions during labor and should be avoided during the last trimester of pregnancy.

Step 3: sucralfate (Carafate® ) has a good record for safety and results with pregnant patients. Acid blockers can probably be administered safely, but require a doctor’s supervision.

Step 4: Other medical therapy should only be used when the benefit of the medicine for the mother outweighs the risk of the medicine to the developing fetus.

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© Jatinder S. Sekhon, M.D.