Most of us have at one time or another suffered the dreaded stomach burning-perhaps after consuming one too many pepperoni pizza slices or maybe that extra spicy Thai dish. Sometimes the condition becomes chronic. Antacid preparations come in different forms and do work reasonably well. However, it turns out that all three types of medication have some significant downsides.

Antacids such as Tums contain calcium. While these work the fastest, they also last the shortest. A few hours of relief is what most people get from these tablets. Yes, the calcium does help prevent osteoporosis or thinning of the bones, but newer research shows that this effect may not in fact be that strong. Also, calcium ingestion has been found to be a cause of atherosclerosis or hardening of the arteries.

The next medication class are PPIs or proton pump inhibitors. Basically, these drugs prevent acid production in the stomach. Included are such pills as Prilosec and Protonix. They work for up to 12 hours or more and after several days of use are very effective. However, there are some major side effects. These include thinning of the bones, jaw bone necrosis, increased risk for aspiration pneumonia (especially if you are undergoing general anesthesia, increased risk for a nasty gut infection called C dificile colitis and most recently discovered lower levels of Vitamin B12. Chronically low levels of this vitamin can cause a type of anemia and long term might even predispose to dementia. Bottom line here is to take the medication only for a few months at a time.

The final type of drugs used to fight off gastritis or esophagitis are H2 blockers which also work to prevent gastric acid production. Think of these as PPI lite. Not as powerful as the previous class of medications, but these drugs have fewer and less serious side effects. They can cause B12 deficiency as well. Overall, they offer better safety in exchange for less effectiveness.

No easy choices here for those of us who suffer from excess stomach acid. However, the good news is that there are other, non medication lifestyle changes which will help. Frequent, small meals and avoiding food after 7 pm will reduce the chances of heavy nighttime acid production. Avoiding spicy foods and eating slowly will do the same. Elevate the head of your bed to allow the stomach acid to remain in your stomach and not migrate up your esophagus. Lose weight and your stomach will feel better.