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Live Right, Live Well

Do You Need a Pill for Stomach Pain?

If living a ''healthy lifestyle'' isn''t working to ease your stomach pain, find out why medication ...

Got stomach pains -- like heartburn, constipation or diarrhea? Sure, you’ve heard the speech about avoiding problem foods and modifying your lifestyle, but sometimes it isn’t enough. And sometimes lifestyle strategies can become so burdensome or restrictive that you can’t, well, enjoy your lifestyle anymore. But that doesn’t mean you have to suffer. There’s a time and place for everything, including medication. So when should you consider a pill when facing digestive distress?

Easing Heartburn
“The severity and duration of your symptoms should determine when to use medication,” says Dr. Richard Desi, a gastroenterologist at Mercy Medical Center in Baltimore.

An over-the-counter antacid will kick in quickly and provide short-term relief; it’s appropriate when occasional heartburn is severe enough to interfere with your daily activities, or doesn’t go away after a couple of hours, says Desi. The same is true if you get occasional acid indigestion after consuming a large meal or eating lots of fatty foods.

H2 blockers are also helpful for occasional bouts of heartburn. They can be taken as needed or before a large meal, notes Dr. Charlene Prather, a gastroenterologist and professor of internal medicine at Saint Louis University. “H2 blockers take 30 to 45 minutes to kick in,” she adds, “but the effects will last for up to 12 hours.”

For persistent heartburn, proton pump inhibitors (PPIs) may be warranted. “They won’t give immediate relief; they can take two to four days to reach maximum effectiveness,” says Prather. But once you’re on a regular regimen (usually a once-a-day dose), relief can be long-lasting. So “if you get heartburn two or more times a week, it may be worth taking a PPI every day.”

Combating Constipation
When constipation drags you down, fiber supplements can help by providing bulk and food for intestinal bacteria, which will help move things along, says Prather. Taking fiber supplements (along with plenty of water) on a regular basis may also help minimize flare-ups of constipation related to irritable bowel syndrome (IBS).

If fiber doesn’t do the trick, Desi suggests a laxative that contains magnesium hydroxide, magnesium citrate or polyethylene glycol. It’s fine to take these occasionally because they are non-habit-forming, notes Desi. For urgent situations -- if you get seriously constipated while traveling, for example -- you might consider a stimulant laxative, such as those that contain senna, sennosides or bisacodyl. But “these can cause cramping and shouldn’t be used long-term because your intestines can become reliant on them,” warns Desi.

Stopping Diarrhea
IBS is a two-sided coin, which can run slow (resulting in constipation) or fast (leading to diarrhea), or even alternate between the two. If you’ve got “the runs” due to IBS or from something you’ve eaten that seriously disagreed with your gut, it’s safe to take an over-the-counter antidiarrheal medication that contains loperamide, says Prather. The same is true if you sometimes get diarrhea when you’re nervous -- right before giving a presentation, for example.

But you shouldn’t take antidiarrheal drugs if you have a fever or bloody bowel movements, says Prather, because these may be signs of food poisoning or a gastrointestinal virus. In these instances, you are better off letting your body get rid of the offending organisms by allowing the illness to run its course naturally.

Quashing Abdominal Cramps
For abdominal cramps resulting from IBS, an antispasmodic medication can help. Talk to your doctor, as these are available only by prescription.

No one likes taking pills, and you should never take medication if you don’t need it. But even experts agree that lifestyle modifications aren’t always enough, and sometimes a pill is just what the doctor would order.