For occasional heartburn, an over-the-counter antacid containing calcium carbonate or magnesium is the fastest option, relieving that burning sensation within minutes. But the best choice depends on how often your heartburn happens, how severe it is, and how long you need relief to last. Several categories of treatments exist, from quick-acting tablets to longer-lasting acid reducers, and the right one for you comes down to matching the remedy to the pattern.
Antacids for Quick, Short-Term Relief
Antacids are the go-to for heartburn that strikes occasionally after a big meal or a glass of wine. They work by neutralizing the acid already sitting in your stomach, which is why they kick in fast. The relief typically lasts a few hours.
The active ingredients vary by brand but fall into a few categories: calcium carbonate (the ingredient in Tums), magnesium hydroxide (found in Milk of Magnesia), aluminum hydroxide, and sodium bicarbonate. Calcium-based antacids are the most popular and double as a small calcium supplement. Magnesium-based options can have a mild laxative effect, while aluminum-based ones tend to cause constipation. Some products combine magnesium and aluminum to balance those gut side effects.
Antacids work best when taken at the onset of symptoms or shortly after eating. They’re not designed for daily, long-term use. If you find yourself reaching for them more than twice a week, a stronger option is worth considering.
Alginates: A Physical Barrier Against Reflux
Alginate-based products like Gaviscon work differently from standard antacids. When alginates mix with your stomach acid, they form a gel-like raft that floats on top of your stomach contents. This barrier is light enough to sit on the surface but strong enough to physically block acid from splashing up into your esophagus.
One study found that alginates are more effective than standard antacids at treating reflux, though slightly less effective than the stronger prescription-style acid reducers. They’re a solid middle-ground option if antacids alone aren’t cutting it, especially for heartburn that flares when you lie down.
H2 Blockers for Longer-Lasting Relief
H2 blockers (the most common one is famotidine, sold as Pepcid) take a different approach. Instead of neutralizing acid that’s already there, they reduce how much acid your stomach produces in the first place by blocking the chemical signal that tells your stomach cells to make it.
The tradeoff is speed versus duration. H2 blockers take about an hour to start working, compared to the near-instant relief of an antacid. But they last significantly longer, making them better for predictable heartburn. If you know a spicy dinner is going to cause trouble, taking an H2 blocker beforehand can prevent symptoms from starting. Many people take one at bedtime to control overnight reflux, or once in the morning and once at night for more persistent symptoms.
A practical strategy: take an antacid for immediate relief and an H2 blocker at the same time to carry you through the next several hours.
Proton Pump Inhibitors for Frequent Heartburn
Proton pump inhibitors, commonly called PPIs, are the strongest acid-reducing option available over the counter. Brands include omeprazole (Prilosec) and lansoprazole (Prevacid). They shut down acid production more completely than H2 blockers and are designed for people dealing with heartburn two or more days per week.
PPIs aren’t meant for on-the-spot relief. You take them once daily before a meal, and they can take one to four days to reach full effect. The standard OTC course is 14 days. They’re the treatment of choice for conditions like GERD (gastroesophageal reflux disease) and erosive damage to the esophagus.
Long-term PPI use has raised some safety questions. The established concerns include a higher risk of bone fractures (from interference with calcium absorption), an increased risk of certain infections, and potential deficiencies in magnesium, iron, and vitamin B12. Earlier worries about links to dementia, kidney disease, and heart disease have been less consistent in follow-up research, and many experts now consider those associations more likely coincidental than causal. Still, the general guidance is to use PPIs at the lowest effective dose for the shortest time needed.
Baking Soda as a Home Remedy
Sodium bicarbonate, plain baking soda, is essentially an unpackaged antacid. Dissolving half a teaspoon in a glass of water can neutralize stomach acid and provide quick relief. You can repeat this every two hours if needed, but shouldn’t exceed five teaspoons in a day.
The catch is sodium. Each dose adds a meaningful amount of salt to your intake, which makes baking soda a poor choice if you have high blood pressure, heart disease, kidney problems, or any condition involving fluid retention. It’s fine as an occasional pinch-hitter when you don’t have anything else on hand, but commercial antacids are more precisely dosed and easier on your sodium load.
Ginger and Herbal Options
Ginger shows some promise for upper digestive symptoms including heartburn, nausea, and that uncomfortable too-full feeling. One small study found that 1,650 mg of ginger per day significantly improved upper GI symptoms. The evidence is still limited, though, and researchers haven’t settled on a standardized dose or preparation. A cup of ginger tea or ginger chews after a meal is unlikely to cause harm and may take the edge off mild symptoms.
A combination of peppermint oil and caraway oil also has moderate evidence for easing upper gut discomfort. Be cautious with straight peppermint, however. While it can soothe the stomach, it relaxes the valve between your esophagus and stomach, which can actually make reflux worse in some people.
Heartburn During Pregnancy
Heartburn is extremely common during pregnancy, and the options narrow somewhat. Calcium-based antacids like Tums are generally considered the first-line choice. The risk of harm to the fetus is highest during the first trimester, and safety after that depends on the specific ingredients and dose. Some antacid ingredients are safe in small amounts while others should be avoided entirely, so checking with your provider about which product and how much is worth the conversation.
Lifestyle Changes That Actually Help
Several non-medication strategies have solid evidence behind them, and they work well alongside whatever you’re taking.
Elevating the head of your bed makes a real difference. People who raised the head of their bed about 11 inches (using blocks, not just extra pillows) had fewer reflux episodes, shorter episodes, and faster acid clearing compared to those who slept flat. A foam wedge pillow achieves a similar effect. If you can only make one change, sleeping position matters too: lying on your left side produces significantly less reflux than lying on your right side. On your right, acid takes longer to clear from the esophagus and the valve between your stomach and esophagus relaxes more frequently.
Waiting at least three hours after eating before lying down is standard advice, though the evidence specifically for avoiding late-evening meals is less airtight. In practice, most people notice a clear connection between eating close to bedtime and nighttime symptoms. Smaller meals, eating slowly, and avoiding your personal trigger foods (common culprits include fatty or fried foods, tomato sauce, citrus, chocolate, alcohol, and coffee) round out the behavioral toolkit.
Heartburn vs. Heart Attack
Heartburn and heart attacks can feel remarkably similar. Even experienced doctors sometimes can’t tell them apart without testing. Typical heartburn is a burning sensation in the chest or upper abdomen that shows up after eating, gets worse lying down, improves with antacids, and may come with a sour taste or a bit of food rising into your throat.
A heart attack more often involves pressure, tightness, or squeezing in the chest that may spread to your neck, jaw, arms, or back. It can also bring shortness of breath, cold sweat, lightheadedness, or sudden fatigue. Women are more likely than men to experience the less obvious symptoms like jaw pain, back pain, nausea, or shortness of breath without classic chest crushing. If your symptoms don’t respond to antacids, feel different from your usual heartburn, or come with any of those additional signs, treat it as an emergency.