I have heartburn every day. It seems to help if I take a half-teaspoon of baking soda in a glass of water. I know there are drugs like Zantac and Tagamet out there. But I would like to know if baking soda is an option.

Rosalie

Heartburn is the most common symptom of gastroesophageal reflux disease (GERD). GERD is caused by reflux of stomach contents and acid back up into the esophagus. This occurs because of temporary relaxations in the sphincter that separates the stomach from the esophagus. Besides heartburn, GERD can lead to chest pain and regurgitation.

GERD is treated by either neutralizing stomach acid or preventing it from being produced. Patients with GERD may instinctively try to swallow when they feel the symptoms of GERD, and they may get immediate relief at times. This is partially because of the neutralizing effect of saliva (which contains bicarbonate, a buffer) on stomach acid. Some people also get relief from milk, or products such as TUMS or other antacids. All of these contain buffers in the form of bicarbonate, which leads to neutralization of acid. Baking soda contains the same buffer.

Certainly baking soda and any of the previously mentioned neutralizing agents can be used to treat GERD. These medications are very safe to use in the recommended doses. However, stronger therapy is often needed because GERD is a chronic disorder and the symptoms tend to recur very frequently, often many times per day.

The advent of medications aimed at inhibiting the production of stomach acid has been a revolution in the treatment of GERD. The first such medications were the H2-blockers, including cimetidine (Tagamet) and ranitidine (Zantac). The introduction of more potent drugs called proton-pump inhibitors (PPIs), such as omeprazole (Prilosec) and lansoprazole (Prevacid), has improved the treatment of GERD even more. In many cases, patients can control their symptoms on one pill per day. There are very few side effects with these medications, and they are used by millions of people worldwide.