When does your heartburn or bloating require more than a trip to the local drugstore? It depends on how frequently your symptoms occur. According to opinion polls, most people wouldn’t call their health care provider just for heartburn.

“People often take over-the-counter remedies for quick relief of acid reflux (heartburn) symptoms,” rather than seeking professional help, says Dr. John Johanson, MD, of the University of Illinois. Unfortunately, they may be missing out on the best remedies for relief and long-term symptom management—especially if their symptoms occur more than twice weekly. Johanson, who presented research at the most recent international Digestive Diseases Week conference, said that while people tend to self-medicate for heartburn, research shows sufferers get greater relief from prescription drugs such as proton pump inhibitors, which block the production of stomach acid.


You know it—the burning feeling that boils up in your throat not long after a big meal, alerting you to the fact that your digestive tract isn’t happy with what just went down. Heartburn is the most commonsymptom of gastroesophageal reflux disease (GERD). More than one in five Americans, especially those who are overweight or obese, experience GERD at least twice a week.

Reflux occurs when the lower esophageal sphincter doesn’t close properly and stomach contents—food and acids—leak back into the esophagus. When stomach acid hits your esophagus, it causes the burning sensation you feel into your chest and throat. Hiatal hernias contribute to GERD; so do obesity, alcohol use, smoking, and certain foods, including citrus fruits, chocolate, caffeinated drinks, and fatty or fried foods.

Over-the-counter remedies may be fine if reflux happens twice a week or less. But experts agree that if you experience reflux more than twice a week, talk to a professional, as GERD can lead to more serious health problems like difficulties in swallowing, scarring of the esophagus, bleeding, and ulcers. Persistent GERD has even been linked to esophageal cancer.

Treating mild, occasional GERD starts with antacids, such as Tums. The magnesium, calcium, and aluminum salts in antacids neutralize acid, stopping symptoms by eradicating the irritant. When GERD becomes persistent, it’s time for either proton pump inhibitors, H2 blockers, foaming agents, or prokinetics. Research indicates proton pump inhibitors (PPIs) such as Nexium, may be the most effective treatment for stopping the burn and healing the esophagus.

H2 blockers, which impede acid production, are often best used at bedtime with a PPI. Foaming agents coat your stomach to prevent reflux. Prokinetics strengthen your sphincter and clear your stomach faster, though they have more side effects than do PPIs or H2 blockers.


While GERD affects your upper digestive tract, problems lower down are typically associated with the cramping, bloating, abdominal pain, constipation, or diarrhea of irritable bowel syndrome (IBS). More than 58 million people suffer from IBS, and 80% are women. IBS is a real medical condition, but it’s not lifethreatening or linked to other serious diseases. However, IBS forces suffers to alter their lifestyle to deal with the symptoms, say researchers at Dartmouth-Hitchcock Medical Center in New Hampshire.

The gastrointestinal tract of someone with IBS processes food more slowly or quickly than the average person. What causes this isn’t known, and there’s no cure, but experts know that stress and certain foods (especially fatty foods) trigger IBS. Report your symptoms to a health care provider right away; it’s important to differentiate IBS from Crohn’s disease and colon cancer.

By paying close attention to your IBS or GERD symptoms and tracking their frequency, you can help your health care provider put you on the right track to symptom control and a higher quality of life.


Since your colon has a complex system of nerves and muscles fibers, women with IBS often experience abdominal muscle spasms in stressful situations. Others suffer symptoms related to their diet, such as a lack of fiber or too much caffeine. Determining which lifestyle or dietary changes are needed can be tricky because, for example, fiber helps constipation, yet it exacerbates diarrhea.

Drinking lots of water, eating smaller meals, and eating often are known to help improve symptoms. Carbonated beverages can cause gas and bloating and should be limited or avoided.

Foods high in carbohydrates and low in fat, such as pasta and rice, can help decrease symptoms, as can limiting milk products. You don’t have to live with a rumble in your tummy; track the frequency of your symptoms and discuss what’s happening in your life with your health care provider—symptom relief may be just an office visit away.

About the Author: Gay L. Goss PhD, RNC, WHNP, CNS, is a women’s health nurse practitioner and associate professor at California State University in Dominguez Hills in California.