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Heartburn/GORD health centre

Treatment tips for severe, chronic heartburn

If you have chronic heartburn or acid reflux, try these heartburn treatments from the experts.
By Rebecca Buffum Taylor
WebMD Feature
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 years.

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 eating.

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 oesophagus.

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 bedtime.
  • 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.

Over-the-counter antacids

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.

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