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A guide to soothing your worst tummy troubles

By Christopher Watters, MD

You know the signs all too well. Your stomach starts gurgling, your chest starts burning, you start cramping — and you begin your frantic search for the bathroom. Digestive problems can be embarrassing, and not something people want to talk about openly — even with their doctor. But as I tell my patients, these problems are strikingly common, and affect many people on a daily basis. 

While digestive problems often go away on their own, over-the-counter medications can help to relieve many of the symptoms that are interfering with your everyday life. Here's a guide to the OTC medicines you can use to soothe tummy or digestive troubles. 

Remember: These medicines are only meant for occasional, short-term use; if your problems persist or worsen, talk to your doctor. He or she can help you come up with a treatment plan (including lifestyle changes) that can bring you long-lasting relief. 

For Heartburn 

If you suffer from heartburn, you're probably all too familiar with that burning sensation in your stomach, chest or throat that can cause discomfort. This irritation is caused by an imbalance of acid in your stomach. 

Heartburn is often triggered by eating a big meal or certain foods, and occurs when your stomach contents rise into your esophagus, causing a burning sensation in the chest, behind the breastbone and in the mid-abdomen. 

Several types of over-the-counter medicines can help to relieve your symptoms and reduce your stomach’s acidity:

• Antacids provide quick, short-term relief by neutralizing stomach acid. Antacids may include ingredients like baking soda, calcium carbonate or magnesium compounds.
   
• Alginic acids are often combined with antacids to provide quick relief. While antacids help to neutralize stomach acid, alginic acids form a protective barrier within your GI tract, coating and protecting inflamed areas.
   
• H2 blockers, like famotidine, cimetidine, and ranitidine, lower the amount of acid your stomach makes. While it takes up to an hour for H2 blockers to work, the effects last longer than antacids, up to 12 hours.
   
• Proton pump inhibitors (PPIs) provide long-lasting reduction, up to 24 hours, in stomach acid production. Lansoprazole and omeprazole are both types of proton pump inhibitors. 

Side effects of these drug classes are usually minor and often resolve on their own. They include nausea, constipation, diarrhea and headaches. Your doctor can let you know which type of OTC medicine will work best for you. Talk to your doctor before using antacids if you are pregnant, breastfeeding, taking prescription medications, or if you have problems with ulcers, the liver or your kidneys.

For Nausea and Vomiting

Last night's Chinese take-out leftovers seem like a great meal idea — until your stomach clearly begins to disagree with you. Nausea and vomiting are one of your body’s major defenses against food poisoning, and can also arise from problems like motion sickness and overeating. While the best way to cure an upset stomach from most cases of food poisoning is to let your body rid itself of the bacteria causing your discomfort, over-the-counter antiemetics can come in handy when dealing with nausea and vomiting symptoms caused by motion sickness and certain other conditions. There are two main types of OTC medications used to treat nausea and vomiting:

• Bismuth subsalicylate, the active ingredient in OTC medications like Kaopectate and Pepto-Bismol, protects your stomach lining. Bismuth subsalicylate is also used to treat ulcers, upset stomach and diarrhea.
   
• Other medicines include cyclizine, dimenhydrinate, diphenhydramine and meclizine. These can be found in medicines such as Dramamine, Bonine, or others, and they dull motion sickness by acting on your brain. They block messages from reaching the part of the brain that controls nausea and vomiting
   

Side effects of bismuth subsalicylate are usually very minor and short-lived; the most common side effects are a darkened tongue or stools. However, it's important not to give medicines with bismuth subsalicylate to children or teenagers with chicken pox or flu-like symptoms, since symptoms such as changes in behavior with nausea or vomiting could be an early sign of Reye's syndrome, a rare but serious illness. Talk to a doctor right away if your child is experiencing such symptoms. Some antiemtics can make you sleepy, so read the label carefully and heed any warnings about mixing with alcohol, driving or operating machinery. Don't take antiemetics without reading the label first, and talk to your doctor if there are any warnings on your medication of choice: there are several drugs and health conditions that don't mix well with antiemetics, including certain common pain relievers. 

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