WebMD Feature Archive
Treatment tips for severe, chronic heartburn
If you have chronic heartburn or acid reflux, try these heartburn treatments from the experts.
Medically Reviewed by
Dr Daniel Rutherford
No matter what you eat, you worry that chronic heartburn will always be
there. You've tried all the antacids, followed a bland diet and given up on
certain foods completely. But still you wake up in the middle of the night,
sometimes with pain deep in your throat, other times with a sore throat and
trouble breathing, as if you were having an asthma attack. You try to sleep
sitting up in a chair, and realise with dismay this has been going on for
Is it chronic heartburn or GORD?
When severe heartburn and acid reflux happen nearly all the time, it could
be gastro-oesophageal reflux disease (GORD). This is the chronic form of acid
reflux, when food and stomach acids "burp" back up from your stomach after
Chronic sufferers often have other symptoms, as well: a sore throat, cough,
asthma symptoms and laryngitis. Left untreated, constant heartburn and GORD can
result in permanent damage to the oesophagus - even cancer of the
Treatment for chronic heartburn
As with any kind of heartburn, start by looking at what you're eating and
when, says pharmacist Tara O'Brien.
Are you overindulging in spicy foods such as tomato-based pasta sauce and
pizza? Citric foods such as orange or grapefruit juice? Overly large meals just
before bed, or too many cups of coffee or alcoholic drinks? It can't hurt to
cut back - or cut them out completely. Here are a few self-care tips:
- Try eating smaller meals, and don't eat two to three hours before
- Avoid foods that may trigger heartburn such as fried food, citrus, tomato,
spices, peppermint, chocolate and fizzy drinks.
- Cut back on alcohol and caffeine.
- Stop smoking if you smoke.
- Lose weight if your doctor says you're overweight.
- Cut back on aspirin and painkillers if you take them often.
However diet and lifestyle changes usually aren't enough to provide relief
when you have chronic heartburn, O'Brien says. It may be time to find the right
medication for your heartburn symptoms.
Antacids can all work for occasional heartburn - although they may not be as
effective for chronic heartburn.
" Digestion works with a cascade of different chemicals produced when you
eat", says O'Brien, "which tell your stomach to produce stomach acid to help
digestion". Antacids neutralise excess stomach acid. But for chronic, severe
heartburn, that may not be enough.
Acid blockers for heartburn and acid reflux
These medicines work by blocking how much stomach acid you produce. Though
not as fast-acting as antacids, acid blockers last longer and can be effective
for several hours at a time. These medicines work by blocking a type of
histamine produced by your stomach, which in turn blocks acid production, says
O'Brien. These histamine blockers are typically taken twice a day, 30 to 60
minutes before eating to be most effective, she says. Her advice: they're best
used as a preventive measure, rather than sudden fast relief of symptoms.