Several things help with heartburn, ranging from quick fixes like antacids to longer-term strategies like adjusting how you sleep and what you eat. The best approach depends on whether you need relief right now or want to prevent heartburn from coming back. Here’s what works and why.
Fast Relief: Antacids
Antacids are the quickest option for heartburn you’re feeling right now. Products like Tums, Rolaids, and Mylanta work by neutralizing stomach acid directly. Calcium carbonate (the active ingredient in Tums) starts working within about 30 minutes and lasts roughly 60 minutes. Chewable tablets tend to work better than swallowable ones.
Combinations of magnesium hydroxide and aluminum hydroxide can last a bit longer, around 80 minutes of relief in the esophagus. On an empty stomach, most antacids wear off within 20 to 60 minutes, so they’re a short-term solution. They’re best for occasional, predictable heartburn, like after a heavy meal.
Moderate Relief: H2 Blockers
If antacids aren’t cutting it, H2 blockers like Pepcid AC (famotidine) reduce the amount of acid your stomach produces in the first place. They take longer to kick in than antacids but last significantly longer. You can take them before a meal you expect will cause problems.
One downside: your body can develop tolerance to H2 blockers over time, meaning they become less effective with regular use. They also struggle to control acid production after meals, which is exactly when heartburn tends to strike. For occasional use, though, they’re a solid middle ground between antacids and stronger options.
Strongest Option: Proton Pump Inhibitors
Proton pump inhibitors (PPIs) like Prilosec OTC, Nexium 24HR, and Prevacid 24HR are the most powerful over-the-counter heartburn medications. They block acid production at its source and provide long-lasting suppression that doesn’t weaken with continued use the way H2 blockers can.
PPIs aren’t designed for immediate relief. They’re meant for people dealing with frequent heartburn, typically two or more days per week. Most OTC versions are intended for 14-day courses. If you’re relying on PPIs regularly, periodic reassessment matters. Long-term use has been associated with potential concerns including nutrient absorption issues (particularly vitamin B12 and magnesium), bone fractures, kidney problems, and gut infections. International guidelines emphasize using the lowest effective dose for the shortest appropriate time.
Baking Soda as a Quick Fix
Sodium bicarbonate, ordinary baking soda, neutralizes stomach acid rapidly. The typical dose for adults is one to two and a half teaspoons dissolved in a glass of cold water after meals, with a daily maximum of five teaspoons. It works, but it’s not for everyone. People with high blood pressure, heart disease, kidney disease, or edema should avoid it because sodium bicarbonate causes the body to retain water. It’s also not appropriate for children under six without medical guidance.
Foods and Drinks That Make Heartburn Worse
Certain foods directly weaken the muscular valve between your esophagus and stomach (the lower esophageal sphincter). When that valve relaxes at the wrong time, acid flows upward. The main culprits are high-fat meals, alcohol, chocolate, and carbonated beverages. All of these reduce the pressure that keeps that valve shut and increase the amount of time acid sits in your esophagus.
You don’t necessarily need to eliminate all of these permanently. Pay attention to which ones trigger your symptoms. For many people, cutting back on fatty and fried foods makes the biggest difference, since fat is the most consistent trigger across studies.
How You Sleep Matters
Sleeping on your left side reduces heartburn more than any other sleeping position. The reason is anatomical: when you lie on your left side, your esophagus sits above your stomach, so gravity works in your favor. Lying on your right side does the opposite, positioning your esophagus below the junction with your stomach and making it easier for acid to flow upward. Right-side sleeping also slows the time it takes for acid to clear from your esophagus.
Elevating the head of your bed by a few inches (using a wedge pillow or blocks under the bedframe) also helps by keeping acid in your stomach overnight. Stacking regular pillows is less effective because it bends you at the waist rather than angling your whole torso.
Other Habits That Help
Eating smaller meals reduces the volume of stomach contents pressing against that valve. Waiting at least two to three hours after eating before lying down gives your stomach time to empty. Tight clothing around your midsection increases abdominal pressure and can push acid upward, so looser waistbands help more than you might expect.
Chewing gum after meals is a surprisingly effective strategy. It increases saliva production, and swallowed saliva both neutralizes residual acid in the esophagus and triggers swallowing motions (peristalsis) that physically clear acid downward. Sugar-free gum works fine for this purpose.
When Heartburn Might Be Something Else
Heartburn and heart attacks can feel remarkably similar. Heart attack symptoms include pressure, tightness, or squeezing in the chest that may spread to the neck, jaw, or back, along with shortness of breath, cold sweat, lightheadedness, or unusual fatigue. Women are more likely than men to experience jaw pain, back pain, nausea, or shortness of breath rather than classic chest crushing.
If you have persistent chest pain and aren’t sure it’s heartburn, call 911. Even if chest pain goes away on its own within a few hours, that still warrants a call to your doctor. Both heartburn and developing heart attacks can produce symptoms that temporarily subside, so the fact that pain resolved doesn’t rule out a cardiac cause.