WITHDRAWAL OF RANITIDINE

In April 2020, the 食品和药物管理局（FDA） requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the U.S. market. This recommendation was made because unacceptable levels of NDMA, a probable carcinogen (cancer-causing chemical), were found in some ranitidine products. If you’re prescribed ranitidine, talk with your doctor about safe alternative options before stopping the drug. If you’re taking OTC ranitidine, stop taking the drug and talk with your healthcare provider about alternative options. Instead of taking unused ranitidine products to a drug take-back site, dispose of them according to the product’s instructions or by following the FDA’s 指导 .

Ranitidine, brand name Zantac, is now marketed as Zantac 360, which contains a different active ingredient (famotidine). Famotidine is in the same class as ranitidine and works the same way but has not been found to contain unacceptable levels of NDMA.

It’s not uncommon to experience heartburn, especially after eating spicy foods or a large meal. According to the克利夫兰诊所, approximately 1 in 10 adults experience heartburn at least once a week. One in 3 experience it monthly.

However, if you are experiencing heartburn more than twice a week, then you may have a more serious condition known as gastroesophageal reflux disease (GERD). GERD is a digestive disorder that causes stomach acid to come back up into the throat. Frequent heartburn is the most common symptom of GERD, which is why the burning sensation is often accompanied by a sour or bitter taste in the throat and mouth.

当您吞咽食物时，它会从喉咙流过您的食管。吞咽的作用会导致控制食管和胃之间的开口（称为食管括约肌）的肌肉打开，使食物和液体进入您的胃中。否则，肌肉保持紧密关闭。

If this muscle fails to close properly after you swallow, the acidic contents of your stomach may travel back up into your esophagus. This is called “reflux.” Sometimes, the stomach acid reaches the lower part of the esophagus, resulting in heartburn.

Eating is a necessity, but getting heartburn doesn’t have to be an inevitable result. There are steps you can take to soothe the feeling of heartburn after a meal. Try the following home remedies to relieve your symptoms.

Wait to Lie Down

You may be tempted to collapse on the couch after a big meal or to go straight to bed after a late dinner. However, doing so can lead to the onset or worsening of heartburn. If you’re feeling tired after a meal, keep active by moving around for at least 30 minutes. Try washing the dishes or going for an evening stroll.

It’s also a good idea to finish your meals at least two hours before lying down, and to avoid eating snacks right before bed.

Wear Loose Clothing

Tight belts and other constricting clothing can put pressure on your abdomen, which may lead to heartburn. Loosen any tight clothing after a meal or change into something more comfortable to avoid heartburn.

Don’t Reach for a Cigarette, Alcohol, or Caffeine

Smokers may be tempted to have an after-dinner cigarette, but this decision can be costly in more ways than one. Among the many health problems that smoking can cause, it also encourages heartburn by relaxing the muscle that normally prevents stomach acid from coming back up into the throat.

Caffeine and alcohol also negatively impact the function of the esophageal sphincter.

Raise the Head of Your Bed

Try elevating the head of your bed about 4 to 6 inches off the ground to prevent heartburn and reflux. When the upper body is elevated, gravity makes it less likely for stomach contents to come back up into the esophagus. It’s important to note that you must actually raise the bed itself, not just your head. Propping yourself up with extra pillows puts your body into a bent position, which can increase pressure on your abdomen and aggravate heartburn and reflux symptoms.

You can raise your bed by placing 4- to 6-inch wood blocks securely under the two bedposts at the head of your bed. These blocks can also be inserted between your mattress and box spring to elevate your body from the waist up. You may be able to find elevating blocks in medical supply stores and some drugstores.

Sleeping on a special wedge-shaped pillow is another effective approach. Awedge pillowslightly elevates the head, shoulders, and torso to prevent reflux and heartburn. You can use a wedge pillow while sleeping on your side or on your back without causing any tension in the head or neck. Most pillows on the market are elevated between 30 to 45 degrees, or 6 to 8 inches at the top.

高脂肪饮食也可能使症状,所以low-fat meals are ideal. In many cases, the lifestyle modifications mentioned here are all you need to avoid or ease heartburn and other symptoms of GERD. However, if your symptoms persist or become more frequent, see your doctor for testing and treatment.

Your doctor may recommend an over-the-counter medicine, such as a chewable tablet or liquid antacid. Some of the most common medications used to relieve heartburn include:

  • Alka苏打水
    (calcium carbonate antacid)
  • Maalox or Mylanta
    (aluminum and magnesium antacid)
  • Rolaids (calcium
    and magnesium antacid)

More severe cases might require prescription-strength medicine, such as H2 blockers and proton pump inhibitors (PPIs), to control or eliminate stomach acid. H2 blockers provide short-term relief and are effective for many GERD symptoms, including heartburn. These include:

  • 西米替丁
    (Tagamet)
  • 法莫替丁
    (Pepcid AC)
  • nizatidine (Axid
    AR)

PPIs include omeprazole (Prilosec) and lansoprazole (Prevacid). These drugs tend to be more effective than H2 blockers and can usually relieve severe heartburn and other GERD symptoms.

Natural remedies, like probiotics, ginger root tea, and slippery elm may also help.

保持健康的体重，服药和保持良好的餐后习惯通常足以抑制胃灼热的火。但是，如果继续发生胃灼热和其他GERD症状，请安排与您的医生预约。您的医生可以进行各种测试以评估您的病情严重程度并确定最佳治疗方法。