What medication do you reach for when you have heartburn or bloating? What about diarrhea? There are many gastrointestinal ailments, but there are even more ways to treat them.
So what’s actually effective at relieving these uncomfortable symptoms?
We asked Maham Lodhi, MD, a gastroenterologist at Rush University Medical Center, to help us match the right remedy with various GI symptoms.
Nausea is one of the most difficult symptoms to treat over the counter, mostly because the medications that are most effective are prescription strength. Nausea is a symptom of many different conditions — from food poisoning and acid reflux to ulcers and cancer treatments — so it's important to see a physician if you’re experiencing persistent nausea, Lodhi says.
Two over-the-counter nausea remedies are more commonly found in the kitchen: ginger and turmeric.
“Ginger has been studied pretty extensively in treating nausea,” says Lodhi. Researchers have yet to determine why it’s so effective, but believe that the active compounds in ginger block serotonin receptors in the stomach that cause the feeling of nausea.
Some studies also show that the anti-inflammatory properties of turmeric make it effective at treating nausea.
Keeping anything down can be a challenge when you’re vomiting, including medication. So it’s best to focus on making sure you don’t get dehydrated — which can be potentially serious.
“I usually tell my patients to take something like Pedialyte after vomiting, just to keep up your hydration,” Lodhi says. Like Pedialyte, coconut milk, watermelon juice and sports drinks all contain electrolytes, the dietary minerals that need replenishing when you’re dehydrated.
Bloating often has multiple causes, so there are a few different approaches to treating it.
The first is following a low FODMAP (or low fermentable carbohydrate) diet, which limits the amount of gas-producing foods you’re eating. Cutting out fermentable carbohydrates — including certain fruits and veggies, dairy products, bread and pasta, beans and lentils, and foods and beverages made with high fructose corn syrup — is effective for treating bloating and irritable bowel syndrome, Lodhi says.
But if you have already eaten a five bean soup and end up full of gas, you may find relief using simeticone, or Gas-X. “We actually do use simethicone when we're doing endoscopies,” Lodhi adds.
If bloating is paired with and caused by constipation, Lodhi recommends using polyethylene glycol, an osmotic laxative, like Miralax or Glycolax.
“People tend to have a very good response to polyethylene glycol if they're taking it correctly,” she says, “It’s very safe; it’s hard to take too much to the point where it’s dangerous.”
By contrast, Lodhi does not recommend using the stool softener docusate sodium, commonly sold as Colace, Correctol and Docusate, for constipation.
Both polyethylene glycol and docusate sodium work by helping the stool retain water. “However, docusate sodium has not been as effective as polyethylene glycol in many studies,” Lodhi says. “Polyethylene glycol has proven to be much more effective at keeping the stool softer which, in turn, helps patients evacuate better.”
When you can’t go more than 10 feet from a bathroom for fear of an accident, it’s understandable to want over-the-counter relief. But Lodhi cautions not to attempt self-treating for diarrhea right away.
“I like to make sure it's not an infection before we start treating it, mainly because when you do have an infection, you want as much of the toxins as possible to come out before you stop up the stool,” she explains.
Some signs that your condition is viral include cramps, body aches, chills or a low-grade fever. Viral infections typically resolve within five to seven days.
“If the diarrhea is not getting better within a week, you should definitely talk to your doctor about it, sooner rather than later,” Lodhi says.
If your symptoms suggest the cause of your diarrhea is not viral, an over-the-counter medication like loperamide HCl (e.g., Imodium) is very effective at stopping diarrhea.
What you use to treat heartburn depends on the circumstances. According to Lodhi, occasional heartburn is best handled with the quick-acting H2 blocker famotidine, better known as Pepcid. Famotidine temporarily blocks the parietal cells of the stomach from reacting to histamine and then creating stomach acid.
But for chronic heartburn sufferers, omeprazole, best known as Prilosec, is more effective. Omeprazole falls in the category of proton pump inhibitors, Lodhi says, which irreversibly block the majority of proton pump cells in the stomach from producing acid.
"This makes them a long-term solution if taken regularly for chronic acid reflux,” she adds.
Otherwise known as dyspepsia or indigestion, an upset stomach is discomfort in the upper gastrointestinal tract that feels almost like heartburn but is not necessarily related to acid. In these cases, Lodhi says taking peppermint may be effective at quelling stomach symptoms where H2 blockers like famotidine (Pepcid) cannot.
In case you don’t have fresh peppermint growing in your garden, products like IBgard and FDgard use peppermint oil to soothe indigestion.
If treatment doesn’t help
If you’ve tried these recommended over-the-counter remedies and your stomach symptoms persist or are more severe than usual, it’s important to consult a physician.
"With the help of your gastroenterologist, you can together determine an individualized plan to treat your specific symptoms and address your concerns,” Lodhi says, “Don't wait. Make your appointment as soon as possible."