A quarter of Britons suffer with heartburn, an uncomfortable digestive issue that quite literally leaves its victims with a bitter taste in their mouth.
Caused by stomach acid leaking up into the oesophagus and throat, heartburn – also known as acid reflux – can be uncomfortable and debilitating.
In extreme cases, GPs prescribe prescription drugs such as omeprazole – a class of medication called proton pump inhibitors – but not every case of heartburn can be classed as ‘chronic’ and ongoing, quite often it’s sporadic and catches you off guard.
The causes are myriad: certain medications, stomach ulcers, pregnancy, smoking and being overweight can all worsen symptoms, and it can also be triggered by diet, alcohol and stress.
With so many people struggling – and so many possible causes – it’s no surprise that a whole swathe of over the counter medications have been developed to extinguish the chest-clutching internal irritation.
One pharmacist, Thorrun Govind, former chair of the Royal Pharmaceutical Society, is regularly quizzed about heartburn treatments – although she is keen to stress that reaching for a syrup or tablet isn’t a longterm solution.
‘Obviously there’s medications available over the counter in the pharmacy, but people also don’t often think about the holistic things that they need to consider with heartburn,’ she tells the Daily Mail.
But when in the grip of a heartburn attack, lifestyle factors are the last thing on your mind – which is why we asked Ms Govind for her steer on which high street remedy is the most effective.
Milk
If you’ve ever been told to drink a glass of milk to quash heartburn there is some science to it – it contains calcium and magnesium which may help temporarily neutralise stomach acid.
Previous studies have even suggested milk has a similar effect to an antacid – a medicine used to combat heartburn – and is comparable to ENO, a dissolvable fizzy tablet remedy.
However, it’s not a viable option for people with a dairy intolerance or allergy, or for vegans. Plus, according to our expert, milk has the potential to make things worse due to how it is digested.
Ms Govind says: ‘Milk can temporarily soothe heartburn as it provides that sensation of cooling, but it’s not going to have any lasting impact.
‘Its effects are very temporary and it can actually cause issues because your stomach may produce more acid to break it down – you may end up causing yourself more problems.’
Govind’s rating: 1/5
Pepto-Bismol
The inimitable bubblegum-pink syrup is the most recognised heartburn remedy in the world, appearing in hundreds of novels, movies and TV shows since its initial inception in 1900.
First developed to treat infant cholera, in 1919 it was remarketed to appeal to adults as a quick and easy way to stop diarrhoea and counter heartburn, indigestion, nausea, gas, belching and fullness – a promise it still delivers today.
Pepto-Bismol works by creating a protective coating over the stomach and lower oesophagus which can ease irritation. Clinical trials have proven that its active ingredient, bismuth subsalicylate, is effective at relieving discomfort related to overindulgence, including heartburn.
However, Ms Govind says it’s not suitable for everyone, and caution is advised.
Govind says: ‘Pepto-Bismol isn’t one of the first things I would think for when I think about heartburn.
‘It’s used for nausea, indigestion, upset stomach, diarrhea and yes, heartburn. But it does contain aspirin, so it’s not suitable for everybody.
‘It can be used in heartburn and acid reflux as it forms a protective coating in your stomach.
‘But you can’t have it if you’re pregnant or breastfeeding. You potentially shouldn’t be having it if you’re diabetic, and it also contains salicylate. This makes it more of an issue with mixing it with other medicines.’
Govind’s rating: 2/5
Milk of Magnesia
Milk of Magnesia – also known as magnesium hydroxide – has shown positive effects as a heartburn and indigestion treatment.
Like milk, the minty liquid has antacid qualities, but unlike the dairy product, it also lowers the amount of acid in the stomach.
This in turn reduces the burning sensation of heartburn – but it might cause issues further down your digestive tract as milk of magnesia is technically a laxative. It can also cause drowsiness in some people.
It’s not suitable for people with kidney issues as it could cause magnesium toxicity.
Govind says: ‘Milk of Magnesia is effective as it relieves indigestion, excess acid, wind, heartburn and stomach discomfort.
‘It is, however, used to relieve constipation, so people might find it has a laxative effect – making it one I would not recommend as strongly.’
Govind’s rating: 3/5
Rennie
It’s estimated that one million Rennie tablets are sold in the UK every day, making it one of the most popular OTC medications in the country.
First launched in 1930, the small square tablets are made from two powerful compounds which neutralise excess gastric acid as soon as they reach the stomach.
They can be chewed or sucked and are suitable for pregnant women.
Govind says: ‘Rennie tablets contains calcium carbonate and magnesium carbonate and are widely used by various people.
‘But I would say they may be slightly less effective than some other remedies.
‘While they work very quickly, they only neutralise acid temporarily. They don’t stop acid from coming back up into the oesophagus.’
Govind’s rating: 4/5
Gaviscon
Their famous adverts depict tiny firemen rushing into the oesophagus to cool the burning sensation of heartburn, with the promise of relief within minutes – and regular users will no doubt tell you that’s an accurate representation of what is happening after they’ve swallowed a spoonful.
Containing an antacid, Gaviscon can also relieve symptoms such as acid-related throat irritation, bad breath and stomach discomfort.
Ms Govind says: ‘Gaviscon forms a protective foam layer that effectively floats on top of the contents of your stomach, effectively creating a barrier.
‘This stops the stomach acid moving up into your food pipe. This is a different mechanism compared to the other remedies.’
Govind’s rating: 5/5
Our expert’s final thoughts
Despite some remedies being ranked better than others by Ms Govind, she warns that many people forget that one of the best ways to target long-term heartburn is to make healthier lifestyle choices.
‘Caffeine, alcohol, fatty or spicy foods can cause heartburn,’ says Ms Govind. ‘Quitting smoking can also really help.
‘It can be caused by or made worse by some medicines like ibuprofen, too. Being overweight can cause or make it worse and in some people, stress and anxiety can also bring it on.
‘I’m of the opinion that we can’t just be thinking about a medicine solving anything. We need to be thinking about our diets, exercise and lifestyle.’
Govind adds that over-the-counter remedies should only be used as a short-term measure, and that persistent or long-term heartburn should be discussed with a medical professional rather than simply relying on medication.
