Behind the burn

Heartburn happens when the muscle between your stomach and esophagus weakens. This lets stomach acid back up into your throat. PPIs stop your stomach from producing most of this acid. This eases painful burning symptoms and can also treat ulcers.

But the relief may come with unintended side effects. Changing the acidity of your digestive system affects your body’s ability to absorb bone-boosting calcium. Long-term use of PPIs may also cause vitamin B-12 deficiency. This damages your nerves and increases your risk for falls.

The FDA issued a warning about a possible increased fracture risk from PPIs. People most at risk, it noted, include:

• Those who take prescription-strength rather than over-the-counter formulas

• Adults ages 50 and older

• Those who take PPIs often or for long periods of time, for a year or longer

Another form of heartburn medicine, called a histamine-2 receptor antagonist, blocks about 70% of your stomach acid. This type of medicine hasn’t shown the same link to fractures.

Other ways to fight the fire

Be sure to talk with your healthcare provider about taking over-the-counter PPIs or histamine 2-receptor antagonists. Your healthcare provider can assess your fracture risk. If it's high, lower doses or different treatments may relieve your heartburn.

Lifestyle changes can also help. Try these medicine-free solutions:

• Don't have foods or drinks that make your heartburn worse. Common culprits include coffee, citrus fruits, tomato-based dishes, chocolate, spicy foods, full-fat dairy, and alcohol.

• Don’t smoke, or get help to quit if you do.

• To relieve pain, take acetaminophen. Aspirin, ibuprofen, and naproxen can irritate your stomach.

• Don’t wear tight-fitting clothing.

• Don't overeat. Eat small meals throughout the day and stop at least 2 to 3 hours before going to sleep.

• Lose weight if you're overweight.

• When in bed, raise your head 6 inches above your stomach with a wedge support.

• Ask your healthcare provider about other medicines that might be weakening your bones. These include warfarin, steroids, thyroid hormones, and some seizure medicines. Don't stop taking these medicines on your own.