Proton pump inhibitors (PPIs) are a commonly prescribed class of drugs for people experiencing symptoms of heartburn.
But a recent study found that using these drugs on a long-term basis could be linked to a shortened lifespan.
The research, led by senior author Dr. Ziyad Al-Aly of the Washington University School of Medicine, pulled data on about 3.5 million people from a national U.S. Department of Veterans Affairs database.
Researchers compared different groups of people: those who used PPIs and those who used histamine H2 receptor antagonists (H2 blockers), along with people who didn’t use either.
In all, those who used PPIs had a 25 percent higher risk of death from all causes versus people who used H2 blockers.
The data is in line with other reported risks of long-term PPI use, including a possible increased riskTrusted Source of bone fractures, the development of microscopic colitis, and a higher susceptibilityTrusted Source to pneumonia.
It’s worth noting that PPIs are generally well-tolerated when taken on a short-term basis.
But ultimately, for those experiencing heartburn, there are a number of simple ways to lessen symptoms — no prescription required.
The best practice for anybody experiencing heartburn symptoms is to consult with their doctor, says Dr. Brenna Velker, a family physician and adjunct professor at Western University’s Department of Family Medicine in Ontario, as well as a blogger at the Huffington Post Canada.
“There are certain things that can cause reflux or gastroesophageal reflux disease (GERD) and you don’t want to treat the symptoms without resolving the issue,” Velker told Healthline.
“If somebody is using a lot of nonsteroidal anti-inflammatory drugs like Advil, they can damage the lining of the stomach and cause irritation, pain, and reflux,” she continued. “So first thing we would say is if you’re taking something like that, stop. Second thing is there’s actually bacteria called Helicobacter pylori that can cause reflux and GERD, so if that’s a possibility, we’d probably want to check that with blood work just to make sure that they’re not positive. If they are, then treating with anti-reflux medications, even a PPI, is not going to fix the problem.”
After consultation with a doctor, if the telltale symptoms of heartburn are, in fact, heartburn and not something more serious, there are a number of ways to ease the pain that don’t involve taking prescription medications.
1. Weight loss
Losing weight and improving general fitness has a positive effect on all facets of health, including heartburn and reflux.
It isn’t hard to visualize the ways that excess weight can exacerbate heartburn symptoms, says Velker.
“The more weight a person is carrying, especially on the abdomen that’s kind of pushing down on the stomach, the easier it is for things to come up through the esophagus,” she explains. “It makes sense, right? There’s more pressure down below, so it’s more likely to go up.”
2. Avoid certain foods
Conventional wisdom dictates that certain spicy foods cause heartburn because their acidity irritates the stomach lining.
But this isn’t necessarily true.
While some foods do indeed irritate the stomach, the true culprit is foods that escape from the stomach and into the esophagus.
They do this by causing the valve that separates the two areas to relax and stop doing its job effectively.
“Certain foods have an effect on the lower esophageal sphincter,” explains Velker. “There’s basically a ring at the bottom of your esophagus where it meets the stomach, and then another ring at the top where it meets the throat. Both of those are supposed to close to make sure that food doesn’t come back up. Certain foods like caffeine, alcohol, and peppermint relax that lower sphincter, and so obviously if you open the door, it’s much easier for it to go through.”
Velker also points out that smoking cigarettes can be a trigger for heartburn as the cigarette smoke tends to relax this valve.
3. Eat less
In a culture where all-you-can-eat buffets are common and children are often implored to clean their plate, it can be tough to make the switch to mindful eating.
While mindful eating — essentially eating slowly and consciously stopping once the body feels full — has a host of beneficial side effects, the most dramatic for people with heartburn may be the way that it reduces symptoms.
It all makes sense when you picture the inner workings of your body — from throat to valve to esophagus to valve to stomach, says Velker.
“This is all physics. If you fill it up, it’s going to be easier for it to overflow,” she said. “If you eat a lot of food or drink a lot of fluid, it’s going to be easier for it to overflow.”
4. Stay upright, stay comfortable
While it might seem like a great idea to lie down for a post-dinner nap after eating a big meal, this is actually a great way to cause heartburn.
“It’s gravity,” states Velker. “You want to use it for you — not against you, so make sure you stay upright for a couple of hours after eating. The typical story is somebody who has spicy food and a beer, has a big meal, then goes to lay down. That is a recipe for disaster.”
Staying upright can help reduce stress on the stomach and esophagus. Another way to reduce stress on these areas is to avoid wearing tight clothing.
“Tight clothing is similar to being overweight: it just puts extra pressure on that stomach,” says Velker. “If you have a balloon, and you’re squeezing the middle of it, you can imagine that if the balloon is open at the top, stuff is going to shoot out the top.”
5. Chew gum
Really? Yes, really.
“There is some evidence that chewing gum might help because it will trigger more swallowing — more saliva production — to kind of rinse whatever’s happening down back into the stomach,” says Velker.
Indeed, a study publishedTrusted Source in the World Journal of Gastrointestinal Pharmacology and Therapeutics found that heartburn symptoms may be reduced by chewing gum for half an hour after meals.
When it comes to understanding heartburn and reflux, it isn’t hard to visualize what’s happening.
“Think of it like a balloon with a tube attached to it,” says Velker. “If the rings are not closed, or if there’s too much pressure on the balloon, or it’s too full, then things will escape.”
While heartburn is a common ailment, it can cause extreme discomfort and even long-term damage related to inflammation and stomach acid.
For these reasons, it’s worth taking steps to lessen symptoms — and see your doctor.
“If you do these things and your symptoms don’t change, do go and see a doctor,” implores Velker. “There are some fairly dangerous things that can present with heartburn as a symptom, like stomach cancer, esophageal cancer, and a lot of other nasty things.”
Ultimately, the best practice for people who want to curb heartburn symptoms without medication is pretty similar to what doctors are constantly telling their patients.
“Essentially: eat well, exercise, don’t eat too much, don’t smoke, and don’t drink too much alcohol,” says Velker. “It’s the stuff that nobody wants to do.”