Heartburn is characterized by a painful burning sensation in the lower chest (substernal area) and can be accompanied by a bitter taste in one's throat. The pain may sometimes radiate up into the chest, into the back, and also less frequently into the throat. If heartburn occurs more than twice a week, an individual may have gastroesophageal reflux disease (GERD; Table 1). GERD occurs when the lower esophageal sphincter fails to close properly and allows the gastric contents to reflux into the esophagus. The gastric acid irritates the lining of the esophagus, causing heartburn.1
Various nonprescription medications (Table 2) have been shown to be effective in treating individuals with heartburn by rapidly relieving symptoms, reducing their frequency and severity, or preventing them from occurring in the first place. The safe and effective use of these medicines always should begin with a thorough assessment of the patient's symptoms to determine whether self-treatment is appropriate or whether the patient should be referred to a physician. Also, in order to ensure a safe and optimal therapeutic outcome, it is essential that the clinician thoroughly evaluate the patient's medical history, concomitant disease states, and medication profile prior to recommending any of these products.
The recommended length of therapy for antacids, histamine2-receptor antagonists, and omeprazole is 2 weeks or less.1 Individuals with symptoms that persist for more than 4 weeks, despite the use of OTC medicines, or those experiencing bleeding, chest pain, stomach pain, and unexplained weight loss should seek medical treatment.