Not too long ago, the Food and Drug Administration gave the green light to a number of pharmaceutical companies to start marketing their "acid-reducing" drugs as "over-the-counter" medications. We have all (by now) been bombarded with information about these drugs, being called by different names but doing much of the same thing. For years, these medications, called H-2 blockers, have been used by physicians to help heal stomach ulcers. They work by reducing the amount of acid secreted into the stomach by "H-2 receptors", hence the name H-2 blockers.
The four major brands of medications now available over the counter are called "Pepcid", "Tagamet", "Axid", and "Zantac". Prior to the approval by the FDA (Food and Drug Administration), these drugs were available only by prescription from your doctor. Before the advent of these drugs (even by prescription), stomach ulcers were treated with surgery, often requiring removal of that part of the stomach affected by the ulcer, which, if left untreated, could often bleed and cause more serious, often deadly problems.
So, what is heartburn and which one of these drugs should you take? Well, if you come right down to the real issue, it really doesn't matter which of the four medications you choose, as they all work in pretty much the same way. It becomes a preference to you, as well as knowing which one seems to "work better for you than others". Pay attention to the symptoms of heartburn, realize the causes, and decide which medication does the best job in curbing the pain and discomfort.
"Heartburn", so called due to it's location (near the heart, as people describe it), is a discomfort caused by acid from the stomach as it is "expelled" into the lower part of the "esophagus" (the food pipe). Usually, people who complain of heartburn also have a problem with the valve which closes over the top of the stomach after food enters from the food pipe; this "valve", which is called the Cardia Sphincter becomes "relaxed" (sometimes caused by smoking cigarettes or even eating peppermint after meals) and it allows the acid to be released into the food pipe. The cells which make up the esophagus (food pipe) are different than those which are in the stomach lining, and are not capable of handling the acid, hence, there is a "burning sensation" - heartburn. Another cause of heartburn (there are a few others, in fact) include a "hiatal hernia", which is a "raising of part of the stomach" above the diaphragm (the muscle which pulls down into the abdomen when breathing). Essentially (and normally), the stomach remains under the diaphragm and the food pipe goes through the diaphragm and then into the stomach. Sometimes, however (as with a good number of people with the problem), the stomach "slides" above the diaphragm, which also "propels" food and acid back into the food pipe, and again causes "burning" in the area, which is described by the patient as "heartburn". The H-2 blockers, such as Tagamet, Axid, Pepcid, and Zantac, are used to reduce the amount of acid available to the stomach; it has been proven that these medications also help "stop" the hiatal hernia. Only in very severe cases is surgery ever still performed for a hiatal hernia.
Besides taking the Acid-Reducers (as they are being called in the laymen literature and the commercials on television), there are a few things one can do to help prevent heartburn. For one thing, one can avoid the symptoms by not eating within a three hour period before going to bed. This works and makes a lot of sense. Since going to bed puts the stomach (and the rest of the body) in a different position, gravity no longer has the same affect on what's in the stomach, and, therefore, there is more of an opportunity for what's in the stomach to get into the food pipe. If food is not there, there is usually little acid also - and there is no longer an opportunity for the acid to cause problems. Additionally, one can avoid peppermint after eating meals (a lot of restaurants offer "peppermint" in a little bowl at the checkout counter - stay away from it if you suffer from heartburn. Peppermint (as well as cigarette smoking) reduces the ability of the "cardia sphincter" to remain closed - and again, there will be heartburn. For people with a more serious problem, sometimes it is advocated that they raise the head of their bed (with blocks) about 30 degrees (or use more than one pillow). This also helps.
Heartburn, in and of itself, is not a danger in the short term, and most people are essentially looking for something to cure the problem and get rid of the pain. Now, they have some medications which are pretty good and work well. However, if heartburn is allowed to persist (without treatment with medications or therapy), there is a risk of developing more serious problems, even cancer of the esophagus. Recall in the first part of the article about the differences in the cell structures in the stomach compared to the esophagus (the food pipe). The cells that line the esophagus cannot "tolerate" the acid for a long period of time without becoming damaged. If the acid is allowed to continuously "damage" the cells, there is a chance of developing serious complications - from severe bleeding, erosion of the lining of the food pipe, and even cancer. Care should be taken when the heartburn persists for a long period of time, even after using many of the medications. If the pain persists after treatment, see your doctor; there could very well be a more serious problem. It should be noted that the "over-the counter" acid reducers" are not intended for the treatment of stomach ulcers or severe complications of "heartburn" - see your physician.
For more information concerning "heartburn", check out the following:
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