Over-the-counter medicines for heartburn
Many medicines against heartburn are available without prescription in pharmacies. These include preparations from the antacids and H2 blockers group. The proton pump inhibitors are available in higher dosages only on prescription.
In lower dosages up to 20mg they are however also available in pharmacies without prescription. In the case of long-lasting and/or severe symptoms, however, drugs against heartburn should only be taken after consulting a doctor. The doctor can first clarify the symptoms and select the appropriate therapy for the individual patient.
Prescription drugs
Antacids are usually not subject to prescription and are available over the counter in pharmacies. The H2-blockers famotidine and ranitidine are also available in low doses; higher doses must be prescribed by a doctor, as must the higher-dose proton pump inhibitors.
What to do if the heartburn does not go away despite medication?
If the heartburn does not go away despite taking medication, there can be various causes. In many cases, heartburn persists because the patient has a lifestyle that promotes the development of heartburn. Important tips are: Reduce excess weight, eat small and low-fat meals, do not eat dinner late at night and do not lie down immediately after eating.
Sleeping with your upper body elevated and on your right side can help with heartburn. You should also avoid foods that cause heartburn particularly frequently. These include: Chocolate, wine and other alcoholic beverages, sour fruit juices, coffee, sparkling water, tomato sauce and garlic.
It also makes sense for a doctor to check whether a patient is taking other drugs that promote heartburn (e.g. anticholinergics for prostate problems, calcium antagonists for high blood pressure, etc.). If heartburn remains severe despite taking medication, the doctor must also look for other, physical causes of the failure. Possibly the patient suffers from delayed gastric emptying, the medication then remains in the stomach longer and is inactivated.
A gastroscopy is performed for diagnosis. If Zollinger-Ellison syndrome exists, the production of gastric acid is increased due to elevated levels of the hormone gastrin. A determination of the gastrin concentration after discontinuing proton inhibitors can rule out Zollinger-Ellison syndrome. Another reason for persistent heartburn may be the intake of NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or diclofenac.