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Pharmacist.comDeveloped by the American Pharmacists Association. Improving medication use. Advancing patient care.
Heartburn happens when stomach acid flows backward, up Three Myths About Heartburn
into your esophagus—the tube that carries food from your mouth to your stomach. Sometimes, partially digested food Myth #1: Heartburn is no big deal. flows all the way to the back of your throat. This backward Fact: Heartburn pain can severely limit what you do and how well you do it. Your health care provider or pharmacist can help If you have heartburn, you don’t need to suffer in silence. Don’t hesitate to ask your pharmacist questions about heartburn, Myth #2: My heartburn is my own fault. and the lifestyle changes and prescription and over-the-counter (OTC) medications that can provide relief. He or she can be Fact: You didn’t cause your heartburn, but you can take a number of steps to lessen its pain and inconvenience.
Use this checklist to decide whether you have heartburn or a Myth #3: Heartburn is not a serious medical problem. Fact: Heartburn can progress to cause more serious problems including these two: IS IT HEARTBURN?
• After meals—or after eating certain foods—do you sometimes • change in the cells of the esophagus lining.
feel a warmth or pain at your breastbone? Yes No Never ignore severe or persistent heartburn. Contact your health • Do you sometimes have an acid taste in the back of your throat? care provider. He or she can do tests to find out whether your heartburn has led to any more serious health problems.
• Do you ever feel that food is coming back into your mouth? Four Ways to Get Your Heartburn Under
• When you lie down, especially after a large meal, do you get Control
The causes of heartburn vary from person to person. These sugges-
• Do these feelings go away when you take antacids or OTC acid tions may help you discover what your personal triggers are.
If you can answer yes to any of these five questions, then you • void certain foods. Be cautious about eating citrus fruits, IS IT MORE THAN HEARTBURN?
tomato products, fatty or greasy foods, chocolates, pepper- mints, vinegar, spicy foods, garlic, raw onions, and black or red pepper.
• Do you have heartburn two or more times each week? away from certain beverages—especially on an empty • Has it lasted for several months? Yes No stomach. The drinks most likely to cause heartburn include coffee, tea, carbonated drinks, citrus drinks and juices, tomato • Do you regularly take medications for it—and it still comes back? smaller, more frequent meals rather than three large meals If you can answer yes to any of these last four questions, you may have a more serious problem.
2 to 3 hours after eating, avoid lying down, bending over Talk to your primary health care provider.
repeatedly, or doing vigorous exercise.
This information was developed in cooperation with advisors for the National Heartburn Alliance™ and made available by the American Pharmacists Association through an educational grant from Procter & Gamble, makers of Prilosec OTC™. 2006, American Pharmacists Association.
Do you need more help than OTC medications can provide? the head of your bed at least 6 inches using a mattress You may need a prescription medication.
wedge or blocks; don’t use pillows.
For prescription PPIs (including Prilosec®, Prevacid®, not eat or snack within 2 to 3 hours before going to bed.
Aciphex®, Protonix®, and Nexium®), you will need to contact your health care provider. Prescription PPIs block your stom- ach’s production of nearly all acid, leaving just enough for nor- mal digestion of food. Another type of prescription medicine, sold under the brand name Reglan®, helps the stomach empty • you are overweight, lose weight—but be sure to consult faster, leading to less acid reflux.
your health care provider before starting a vigorous exercise program.
When to Ask for Help
• void tight-fitting, restrictive clothes.
You may hesitate to contact your primary health care provider Know your reaction to your medications. about heartburn. However, if lifestyle changes and OTC medi- of your prescription or OTC medications may cause cations don’t ease your discomfort, your health care provider can offer several other treatment options. Your pharmacist can help you decide whether further medical help for your heart- your pharmacist or health care provider about alterna- tives—but never stop taking a prescription medication on your own.
This checklist will help you know when to make the call. SHOULD YOU CALL YOUR PRIMARY
Medications Can Give You Relief
HEALTH CARE PROVIDER?
Some people are confused by the large number of heartburn • Have your symptoms lasted for more than 14 days? Yes No medications available. Matching your symptoms to the proper • Do your symptoms continue even after you take OTC heartburn Do you get heartburn just every once in a while? • Does heartburn or reflux wake you from sleep? Yes No Try an OTC medication.
• Do you often have a sore throat, severe hoarseness, or wheezing? An OTC medication, such as an antacid or H2 blocker, may work well for you. Your pharmacist can help you choose among the • Are you bothered by nausea or vomiting? Yes No • Have you noticed an unexplained weight loss? Yes No Antacids neutralize stomach acid. They work quickly and If you can answer yes to any of these questions, make an appoint- give temporary relief that lasts 1 to 2 hours. Some brands are ment with your health care provider—but read on.
SHOULD YOU SEEK HELP RIGHT AWAY?
H2 blockers reduce the amount of acid your stomach makes. • Is swallowing difficult or painful? Yes No They give relief that lasts 6 to 12 hours. Some brands are Tagamet HB®, Pepcid® AC, Axid® AR, and Zantac 75®.
• Are you vomiting blood or noticing blood in your stool? Yes No (Blood in vomit can look like coffee grounds. Do you get heartburn 2 or more days a week? Blood from the stomach that appears in the stool may be black or tarry looking.) Change your OTC medication.
If you can answer yes to either of these questions, see your This type of heartburn is called frequent heartburn. To treat it, you might need a medication called a proton pump inhibitor (PPI). One PPI, Prilosec OTC™, is now available without a pre- More Information
scription. Prilosec OTC™ is the only OTC medication indicated specifically for frequent heartburn. When taken as directed for 14 days, it provides 24-hour relief of frequent heartburn symp- on to www.heartburnalliance.org or call toll free toms. If symptoms persist longer than 14 days, you should see Know Your Medicine • Know Your Pharmacist
International Journal of Antimicrobial Agents 21 (2003) 267 Á/273b-lactamase production in Provotella and in vitro susceptibilities toL. Dubreuil a,, J. Behra-Miellet a, C. Vouillot a, S. Bland b, A. Sedallian b, F. Mory ca Faculte´ de Pharmacie, 3, rue du Professeur Laguesse, BP83, Lille Cedex 59006, FranceReceived 21 May 2002; accepted 1 July 2002This study looked for b-lactamase producti