Find Your Heartburn Relief: Understanding PPIs, Antacids & H2 Blockers
Introduction
That familiar burning discomfort rising after eating, often called heartburn, can be a frequent issue for millions of Americans.
Some people get it occasionally, maybe after eating spicy foods or drinking coffee. Others deal with it more regularly, sometimes even daily. If you’re in that second group, managing it effectively becomes more important, and knowing the different options available can make a difference.
Managing Heartburn
Navigating the world of heartburn remedies can feel overwhelming. Drugstores are filled with various pills and liquids, each promising relief. It's important to understand how these different options work so you can make informed choices about what's best for you.
To find relief from heartburn, the three main classes of medications available are proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2 blockers), and antacids, all accessible with a prescription or for over-the-counter purchase. Each of these medications reduce stomach acid, which is crucial because excess acid can reflux into the esophagus (the tube from your mouth to your stomach) and cause heartburn. However, they all function quite differently.
PPIs explained
Proton pump inhibitors (PPIs) are medications that reduce stomach acid production, offering relief from frequent heartburn. Unlike treatments that neutralize acid after it's produced, PPIs work at the source by targeting the mechanism that produces stomach acid in the first place.¹
How PPIs work
PPIs function by blocking enzymes in the stomach lining called "proton pumps." These pumps are responsible for producing stomach acid. By inhibiting these pumps, PPIs reduce the amount of acid your stomach produces, preventing heartburn before it can start. This preventive approach is the main difference between PPIs and other heartburn medications.¹
PPIs aren’t meant for quick, one-time relief but rather for those who want a more long-term solution.
Prilosec OTC
Prilosec OTC is a popular over-the-counter proton pump inhibitor (PPI), in fact it was the first over-the-counter treatment for frequent heartburn². It provides relief from frequent heartburn: just one pill a day offers 24 hours of protection. That’s day and night coverage — all from a single daily dose. Unlike treatments that only ease symptoms after they start, Prilosec OTC works by helping to prevent the root cause — excess acid — before it begins. This makes it particularly helpful for those who need consistent, long-lasting relief from frequent heartburn.
H2s explained
Histamine-2 (H2) blockers represent a middle ground between antacids and PPIs in terms of how they work and how long their effects last. They’re not quite as strong or long-lasting as PPIs, but they last longer than antacids and can be taken before meals to help prevent heartburn.³
How H2s work
H2 blockers reduce acid production by blocking histamine, a natural chemical that signals stomach cells to produce acid. By interrupting this signal, H2 blockers decrease the amount of acid the stomach produces.³
These medications don't work as quickly as antacids; however, their effects last longer than, usually for several hours. ³
H2 blockers are good for people who experience heartburn a little more regularly than “once in a blue moon” but not quite every day. They’re also sometimes used in combination with other treatments, though this depends on individual needs and what your doctor recommends.³
Antacids explained
Antacids represent one of the oldest and most familiar treatments for heartburn. These over-the-counter medications work directly on stomach acid after it's produced.⁴
How antacids work
Antacids contain calcium carbonate, magnesium hydroxide, or aluminum hydroxide that chemically neutralize stomach acid. They raise the pH level of the stomach contents, making them less acidic and thereby reducing the burning sensation of heartburn.
Unlike PPIs, antacids work immediately when they come in contact with stomach acid. This makes them useful for quick relief when heartburn strikes unexpectedly.
Comparison Summary
When choosing a heartburn treatment, consider these key differences:
| PPIs | H2s | Antacids | |
|---|---|---|---|
| Relief Duration | Up to 24 hours | Up to 12 hours | 1-3 hours |
| When to use it | Frequent heartburn | Occasional heartburn | Occasional heartburn |
So, if you’re someone who only feels heartburn once in a while after a big plate of nachos, an antacid might be all you need. But if heartburn is a daily hassle, you might want to consider long-term treatment. Remember that while these medications can effectively manage symptoms, persistent heartburn should be discussed with a healthcare provider to rule out more serious conditions and ensure you're using the most appropriate treatment for your specific situation.
Sources:
-
Proton Pump Inhibitors (PPI). National Library of Medicine. Last updated May 1, 2023. Accessed June 5, 2025.
https://www.ncbi.nlm.nih.gov/books/NBK557385/ -
Prilosec OTC (omeprazole) Information. U.S. Food & Drug Administration. Last updated November 27, 2015. Accessed June 5, 2025.
https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/prilosec-otc-omeprazole-information#:~:text=The%20Food%20and%20Drug%20Administration,counter%20treatment%20for%20frequent%20heartburn -
H2 Blockers. National Library of Medicine. Last updated August 11, 2024. Accessed June 5, 2025.
https://www.ncbi.nlm.nih.gov/books/NBK525994/ -
Antacids. National Library of Medicine. Last updated August 8, 2023. Accessed June 5, 2025.
https://www.ncbi.nlm.nih.gov/books/NBK526049/