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wikiHow to Treat Heartburn

Four Parts:Understanding HeartburnAdjusting Your LifestyleUsing Natural and Alternative TherapiesTreating Heartburn with Medication or SurgeryCommunity Q&A

Most people have heard of heartburn, but do you really know what it is or what causes it? Heartburn, or gastroesophageal reflux (GERD), is the most common symptom of having too much stomach acid. This excess stomach acid leaks into the esophagus, causing pain and even severe health problems. If you experience heartburn frequently (more than once a week), you may have gastroesophageal reflux disease, GERD. Treatment is important to prevent severe damage. Fortunately, there are a variety of treatments available.

Part 1
Understanding Heartburn

  1. 1
    Learn how stomach acid normally helps in digestion. Acidic liquid is naturally-produced by the stomach to help your body break down and digest food. The acid is secreted by parietal cells in the the stomach in response to stimulation by gastrin. It also kills pathogens in your gastrointestinal tract which can prevent infection. There's no way to completely eliminate stomach acid, nor would you want to.
    • If you notice discomfort or inflammation, you'll need to determine if excess stomach acid is causing the pain.
  2. 2
    Recognize the symptoms of gastroesophageal reflux disease (GERD). Pay attention to any signs or symptoms of discomfort associated with GERD. These include:[1][2][3]
    • Burning and/or sharp chest pain, beneath the sternum (your chest). This burning feeling can extend into your back, neck, and jaw, lasting from seconds to hours. Many people mistake this pain for a heart problem (like.a heart attack or angina). If you are having jaw or arm pain or have a high suspicion that it is chest pain, seek medial attention.
    • Regurgitation of stomach contents (which tastes like a sour, burning liquid) into your throat and mouth. This can cause a bad taste and increased salivation. You may also feel like you have a lump in your throat.
    • Decreased hunger or early satiety (needing less food to feel full).
    • Nausea or sharp, central/upper abdominal pain.
    • Chronic cough because your throat is irritated.
  3. 3
    Learn what causes GERD. Your body has ring of muscle, the lower esophageal sphincter (LES), that tightens and closes the end of your esophagus where it meets your stomach. This blocks what's in your stomach from traveling back out of the stomach and it ensures that your stomach opens only when you swallow or belch. Sometimes, the LES can fail, causing stomach acid to travel out of the stomach and up into the esophagus. This can happen if:[4][5][6]
    • Your stomach is too full (from overeating) or after eating foods that cause bloating and increased gas production (like cabbage, broccoli, Brussels sprouts, legumes, dairy, high-fat foods).
    • You strain frequently, like when you lift heavy objects, or exercise vigorously right after eating.
    • You have a hiatal hernia. This is when the top part of your stomach moves up through the opening in the diaphragm (where the esophagus travels from the chest into the abdomen).
    • You are overweight, obese, or pregnant. The extra weight on your stomach can increase the pressure across your your stomach, LES, and esophagus.
    • You lay down too soon after eating a meal. Normally, gravity helps the LES by keeping stomach contents in the lower part of the stomach. If you lay down after eating, the contents can push up and through the LES.
    • You eat foods that irritate the lining of your esophagus and throat, which can cause inflammation and loosen your LES. Irritants can include caffeine, alcohol, spicy foods, acidic foods, and nicotine, which can increase acid production.

Part 2
Adjusting Your Lifestyle

  1. 1
    Improve your diet. Diet and weight management should be the first steps in treatment. Aim for a healthy, balanced diet that has lots of fruits, vegetables, whole grains, and low-fat or fat-free dairy (avoid dairy product with added sugar and higher calorie content). You should also include lean (low-fat) proteins, like poultry, fish, and beans. Try to cut down saturated and trans fats, cholesterol, and avoid things that are high in sodium (salt) and added sugars.
    • The U.S. Department of Agriculture has a variety of guidelines and nutrition resources available to create your own balanced diet.[7][8][9]
  2. 2
    Avoid foods that trigger your heartburn. While there are no specific foods that have been scientifically proven to cure GERD, you can try treating symptoms with natural remedies or avoiding the foods that trigger your heartburn. These trigger foods might include:[10][11][12]
    • Caffeine: coffee, tea, soda
    • Alcohol
    • Caffeine-like chemicals: chocolate, peppermint
    • Spicy foods: hot peppers, curry, hot mustards
    • Acidic foods: citrus fruits, tomatoes, sauces and dressings containing vinegar
  3. 3
    Change how you eat. Avoid eating large portions of food. Large, poorly chewed bites can over-fill your stomach, since it takes longer for your stomach to break down food. Instead, eat smaller portions slowly, taking small, thoroughly chewed bites.[13] This will make digestion more efficient and keep you from ingesting extra air, which can cause bloating.
    • Take your time when you eat. It can take up to 20 minutes for your stomach to signal your brain that you are full. Because of this, people who eat quickly tend to eat more and be more prone to over-filling.
  4. 4
    Get to a healthy weight. Use a body mass index (BMI) calculator to determine your healthy weight range according to your height and sex.[14] To lose or maintain weight, count calories by estimating your daily calorie needs and track how many calories you eat. You can simply estimate your daily calorie needs by multiplying your weight in pounds by 10. This number can change, depending on your age, gender, and activity level. For an easier, more accurate calorie estimate, use an online tracker or phone application.[15][16][17][18][19]
    • A normal BMI is 18.5-24.9. BMIs below 18.5 are underweight, from 25.0-29.9 are overweight, and above 30.0 is defined as obese.
    • The healthiest rate to lose weight is at about one pound per week. A pound of fat is equal to 3500 calories. If you decrease your daily calorie intake by 500, you will lose about one pound per week (500 calories x 7 days/week = 3500 calories/7 days = 1 lb/week).[20]
  5. 5
    Exercise mindfully and regularly to lose or maintain a healthy weight. Adults should try to get at least 30 minutes of moderate intensity activity at least 5 days a week (for a total of 150 minutes). Or, try to get at least 25 minutes of vigorous aerobic activity at least 3 days a week and moderate to high intensity muscle strengthening at least twice a week.[21] Do your best to get as much exercise as you can, even if it's just going for a short walk.[22]
    • If you exercise beyond your normal daily activities, you'll be burning calories that can be added to your daily caloric intake. Don't forget that you can track these activities on any fitness logs you use.[23]
    • Remember not to strain or exercise vigorously, especially right after you eat. Give your body time to digest food (3 to 5 hours) or eat smaller meals before exercising.[24][25]

Part 3
Using Natural and Alternative Therapies

  1. 1
    Use baking soda. Baking soda, sodium bicarbonate, works as an antacid which can neutralize stomach acid. To use baking soda powder as a treatment, stir ½ to 1 teaspoon of baking soda in a glass of water and drink it. You can do this every 2 hours to relieve heartburn.[26]
    • Baking soda is also available in a capsule or pill form, over-the-counter or by prescription. If you're treating children with baking soda, be sure to ask your doctor's advice about dosing.[27]
  2. 2
    Drink ginger or chamomile tea. Crush 2 to 3 roots of ginger and boil them in water for 5 minutes. Drinking a ginger or chamomile tea might reduce stress, relieve nausea, and help with digestion. Try drinking 1 or 2 cups of ginger tea about 20 minutes before a meal to calm your stomach and help with digestion.[28]
    • If you notice your GERD is worse when you lay down, try drinking a cup of chamomile tea 30 to 60 minutes before bed. It's thought that this might reduce stomach inflammation and could balance acidity levels.[29]
  3. 3
    Eat licorice. This is a plant that many suggest may help symptoms of GERD. Look for deglycyrrhizinated licorice (DGL) which comes as a powder or tablet. Slowly chew 2 tablets or take 1/2 teaspoon of powder 15 minutes before your meals.[30] Studies show that taking a licorice product that also contains peppermint leaf, German chamomile, caraway, lemon balm, clown’s mustard plant, celandine, angelica, and milk thistle 3 times daily for 4 weeks can reduce your GERD symptoms.[31]
    • Licorice can interact with medications you may be taking, so speak with your doctor before taking it.[32]
  4. 4
    Chew gum or suck on lozenges. Chew gum or suck on the lozenges after eating to help your body digest the food. These can make you salivate more, which has been shown to neutralize stomach acid.[33] Choose sugar-free gums or lozenges to avoid extra calories.
    • Sugar-free gums and lozenges are also a better choice than full-sugar options, which can cause harm your tooth enamel and cause cavities.[34]
  5. 5
    Drink aloe vera juice. While studies are needed to prove this connection, some claim that drinking ½ cup of aloe juice may soothe inflammation in your esophagus.[35] Be sure to drink it cool or room temperature before you're ready to eat a meal.
    • Aloe vera can have laxative qualities, so be prepared before drinking it.[36]
  6. 6
    Try acupuncture treatment. Acupuncture is an ancient therapy that uses strategically placed needles on your body to stimulate certain points. Studies have shown that it can significantly improve regurgitation and heartburn. Specifically, acupuncture can change your stomach's acid secretion, alter digestion, and relieve pain.[37]
    • Be sure to find an acupuncturist who is trained and certified. You can check the directory on the National Certification Commission for Acupuncture and Oriental Medicine's website to find someone in your area.[38]

Part 4
Treating Heartburn with Medication or Surgery

  1. 1
    Know when to see a doctor. If you've made changes to your lifestyle and diet without noticing any symptom relief, see your doctor. Treatment of GERD is critical to prevent severe health problems, like injury or inflammation to your esophagus. The longer your esophagus is inflamed or repeatedly injured, the higher your risk of developing esophageal cancer.[39][40]
    • Your esophagus lining usually protects itself from stomach acid, but lasting GERD can wear down these defenses.
    • You may actually suffer from a bacterial stomach infection Helicobacter pylori (H. pylori) that might contribute to GERD symptoms. Your doctor will be able to test for the bacteria, which could eventually lead to cancers of the stomach, and suggest a treatment regimen.[41][42]
  2. 2
    Understand tests for GERD. Usually, GERD is diagnosed based on the clinical symptoms you describe. But, if you've had reflux for a long time or if it doesn't react to medical therapy, you'll probably need to have an upper endoscopy screening. This procedure uses a camera attached to a flexible tube that is placed down the throat to view the throat, esophagus, and stomach. Several biopsies, or tissue samples, are usually taken to determine how inflamed your stomach and esophagus are. Your doctor will then suggest a treatment regimen.[43][44]
    • During the endoscopy, your doctor will check for H. pylori, the bacteria that may cause GERD symptoms. If your doctor finds it, you'll usually be placed on a triple therapy regimen that includes a proton pump inhibitor (for excess stomach acid), amoxicillin and clarithromycin (antibiotics), which will all be taken twice daily for 7-14 days.[45][46]
  3. 3
    Take antacids. To treat mild to moderate GERD, your doctor may recommend taking antacids, in addition to making lifestyle changes and monitoring your diet. Antacids, like calcium carbonate, Tums, or Maalox, are OTC medications that neutralize acid and can be taken as needed, following the packaged instructions. While antacids work quickly, they effects wear off after about an hour. Only use them if you have symptoms once or twice a week.[47][48]
    • If you over-dose, you may get “milk-alkali syndrome,” which has symptoms including nausea, vomiting, weakness, psychosis, and kidney injury/failure. This comes from getting too much calcium and making the body too alkaline.
  4. 4
    Take surface agents. Surface agents, like sucralfate/Carafate stick to the surface of your esophagus and stomach to protect and heal them. You can usually take them as pills or liquids 2 to 4 times a day for 4 to 8 weeks to treat mild to moderate GERD. Side effects are minimal, unless you take them incorrectly for a long time.[49][50]
    • Many of these surface agents have aluminum, and can lead to aluminum toxicity if taken incorrectly. Symptoms of aluminum toxicity include bone/muscle pain, weakness, anemia, and confusion.
  5. 5
    Try Histamine 2 receptor antagonists (H2RAs). H2RAs, like cimetidine, ranitidine/Zantac, famotidine/Pepsid,nizatidine block a signalling pathway in the cells of your stomach which then decreases secretion of acid. Take H2RAs as pills twice a day for 2 to 6 weeks to treat mild to moderate GERD. Several types are available OTC and are remarkably safe.[51][52]
    • Uncommon and rare side effects include: gynecomastia (breast formation in men), impotence, liver dysfunction, confusion, restlessness, low blood pressure, low heart rate, and anemia.[53][54]
  6. 6
    Take proton pump inhibitors (PPIs). PPIs, like omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole, rabeprazole are the strongest medications for preventing acid secretion in the stomach. If you have severe GERD with 2 or more episodes of reflux a week, take a PPI (some of which are available OTC). Generally, you should take 1 pill a day, 30 minutes before the first meal of the day, for 8 weeks. Side effects of these include:[55][56][57]
    • Bacterial infections of the GI tract which cause diarrhea (like C. difficile, Campylobacter, Salmonella) and pneumonia. Since your stomach acid is reduced and not blocking as much bacteria, these bacterial infections are possible.
    • Malabsorption: the effects are usually low, but PPI’s can reduce your absorption of iron, vitamin B12, magnesium, and calcium. This can lead to anemia and osteoporosis if PPI’s are taken for very long periods of time.
    • Drug interactions: taking PPI’s can affect the absorption and metabolism of other drugs. The well-known example of this is with a drug called clopidogrel, which is used to prevent clotting.
  7. 7
    Get surgery. It's rare, but if your GERD symptoms aren't helped by any medical therapy, you may need surgery. Surgery is also an option for young people who may need life-long therapy otherwise. One type of surgery, fundoplication, reinforces your lower esophageal sphincter (LES) by wrapping and sewing a part of your stomach around the esophagus.[58][59]
    • Another type of surgery closes your lower esophagus by wrapping a string of magnetized beads around your stomach, esophagus, and LES. The beads allow for expansion to let food through.

Community Q&A

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    • Avoid eating late at night. Sleep with the head of your bed raised 6-8 inches, and don’t lie down immediately after a meal.
    • Avoid caffeine, alcohol, and tobacco.
    • Not much research has been done on the effects of natural remedies, herbal supplements, or alternative therapies on GERD. You may have heard that peppermint can be helpful, but it has actually been show that peppermint oil worsens heartburn.[60][61][62] Milk is also commonly thought to relieve symptoms. While, milk will temporarily neutralize stomach acid, the fat and lactic acid in milk can stimulate more acid production.
    • Many OTC medications can also be prescribed, which could make them covered by insurance.


    • If you try treating your heartburn at home and notice that you symptoms are not going away, talk to your doctor about getting prescription medication.
    • Many medications for GERD are available over-the-counter (OTC), but it is important to talk with your healthcare provider to ensure a proper treatment regimen.

    Sources and Citations

    1. Kahrilas, Peter J. “Clinical manifestations and diagnosis of gastroesophageal reflux in adults.” UpToDate. <>.
    2. Fass, Ronnie. “Approach to refractory gastroesophageal reflux disease in adults.” UpToDate. <>.
    3. Kahrilas, Peter J. “Pathophysiology of reflux esophagitis.” UpToDate. <>.

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