Did you know that about one in every six adults—that’s nearly 60 million Americans—experience symptoms of heartburn at least once a month? But how many of you really understand what heartburn is, and what causes it? Hi, I’m Dr. Frank McGeorge for Prilosec OTC, and today we’re going to talk about the causes of frequent heartburn—the first video in this series. Heartburn is usually felt in the chest, just behind the breastbone. It’s the pain you feel when harsh stomach contents come into contact with the delicate lining of your esophagus, causing irritation. Now, it’s important for you to know heartburn affects everyone differently; for some it feels like a burning pain that begins in the chest and moves up toward the throat. For others, it feels like food is coming back up into the mouth, or it’s an acidic or bitter taste at the back of the throat. Now, heartburn pain usually starts soon after you eat, and it can increase in severity when you lie down or bend over. Heartburn occurs when the lower esophageal sphincter, or LES—that’s the natural valve that allows food into the stomach, but not out—relaxes, or stops functioning properly. When that happens, acidic stomach juices reflux, or flow backward into the esophagus. But there are other factors that can contribute to heartburn, including eating an acidic food, like tomatoes or citrus fruits; drinking alcohol; smoking cigarettes; and certain medical conditions like diabetes or asthma. Now, in addition, excessive pressure on the abdomen can put pressure on the lower esophageal sphincter, allowing stomach acid to enter the esophagus or even the mouth. For that reason, if you’re pregnant or overweight, you might be especially prone to heartburn. In fact, even tight-fitting clothes can cause pressure that leads to frequent heartburn; so can lying down, or having too full of a stomach. Now, generally, heartburn experts tend to use three categories to describe heartburn frequency: episodic, frequent, and persistent. Episodic or occasional heartburn refers to infrequent flare-ups that are fairly predictable and occur less than once a week (for example, after that all-you-can-eat buffet). This kind of heartburn is usually treated with antacids. Now, at the other end of the spectrum is severe or persistent heartburn. These are painful, long-lasting episodes of heartburn that may occur most days, if not all the time. Persistent heartburn should be assessed and treated by a medical doctor. Now, for many of us, though, frequent heartburn is the middle category problem. This means that you’re experiencing heartburn symptoms two or more days a week. If you’re having symptoms that often, you may want to consider taking a more proactive approach by reducing excess acid production that’s causing frequent heartburn, rather than waiting and treating your symptoms every time they occur. So, what can you do? Well, there are a number of heartburn medications to choose from that work differently. Antacids like Tums® neutralize stomach acid on contact and they’re great for relieving symptoms immediately, but the relief is only temporary. Now, H2 blockers like Pepcid® AC® or Zantac 75® work by reducing excess stomach acid. H2 blockers begin working within an hour and they last up to 12 hours, but they don’t provide the immediate relief of an antacid; and although preventative, H2 blockers may not avert heartburn as long with a single pill compared to proton pump inhibitors. Proton pump inhibitors, or PPIs, like Prilosec OTC, are the most frequently recommended therapy blocking heartburn for 24 hours with just one pill a day. And here’s how they work: When you eat, millions of tiny pumps in your stomach produce acid to break down food. H2 blockers inhibit a portion of the receptors and they last about 12 hours, while proton pump inhibitors actually shut down some of the pumps, reducing the excess acid that causes heartburn while leaving enough behind to digest your food. PPIs don’t provide immediate relief, but they can block heartburn before it starts, and they do it for a full 24 hours with just one pill a day. Now, by the way, be sure to talk to your healthcare professional if you think any other medications you’re taking might be contributing to your heartburn. Also, ask about alternatives and never stop taking any prescription medication before checking with your doctor. I’m Dr. Frank McGeorge for Prilosec OTC.