Even if you maintain the healthiest eating regimen and drink plenty of water, sooner or later you’re going to experience gastrointestinal distress, says Dr. Brijen J. Shah, an associate professor of gastroenterology at Mount Sinai Medical Center in New York City. “Gastrointestinal issues are common and can occur due to diet, infection, side effects from medications and stress,” says Shah, who’s a spokesperson for the American Gastroenterological Association.
People experiencing digestive distress should be aware of how changes in their life circumstances — like the ongoing COVID-19 pandemic — could be affecting their levels of stress and make their health care providers aware, Shah says.
Am I Experiencing Digestive Problems?
Common signs of gastrointestinal distress include acid reflux, chronic bloating, unexplained weight loss and problems swallowing.
To help consumers decide which over-the-counter products to select for digestive maladies, U.S. News, in partnership with Pharmacy Times, surveyed pharmacists on a variety of OTC health products. There are a number of safe and effective over-the-counter medications available to relieve the symptoms of the most common gastrointestinal problems, which are:
— Heartburn, or indigestion.
Heartburn is a broad term that includes symptoms such as chest burning, indigestion and pain at the top of the stomach, which can sometimes be accompanied by nausea, Shah says. These symptoms can be triggered by eating certain foods, like spicy or rich offerings, caffeine and alcohol. For people who are lactose intolerant, consuming even a small quantity of cow’s milk or another dairy product can trigger heartburn.
Nausea can be triggered by the slow emptying of the stomach, which is caused by medications and chronic diseases like diabetes, Shah says. Acute instances of nausea can lead to vomiting. Excessive drinking can also lead to nausea and vomiting.
Constipation is a common condition that’s often attributable to the slow movement of the colon, a lack of dietary fiber and poor function of the pelvic floor during defecation, Shah says. Many people experience bouts of constipation when they’re traveling and not in their usual eating and exercise routine. Not drinking enough water or getting enough exercise can also cause constipation, Shah says.
Diarrhea is characterized by “passing loose, watery stools three or more times a day,” according to the National Institute of Diabetes and Digestive and Kidney Diseases. The condition can also cause cramping, an urgent need to use the bathroom and abdominal pain. Diarrhea can be caused by a viral, bacterial or parasitic infection. “Travelers’ diarrhea” can also be triggered by consuming foods or beverages “contaminated with bacteria, viruses or parasites,” according to the NIDDK.
OTC Products for Heartburn
Eating a large meal or consuming something that disagrees with you are common causes of heartburn, says Dr. Scott Gabbard, a gastroenterologist at Cleveland Clinic. OTC medications that neutralize acid in the stomach can be quite effective. “They work very quickly, within a couple of minutes,” he says.
It’s important to read the recommended dosage for these products. For example, Prilosec OTC advises that adults age 18 and older should not use the medication more than once a day. The recommendation is to take one tablet every day for 14 days. The product should be kept out of the reach of children.
Prilosec was recommended by 34% of pharmacists surveyed, and Pepcid and Nexium followed with 31% and 16%, respectively. These are the top recommended acid-reducing OTC medications:
— Prilosec OTC.
— Nexium 24HR.
— Prevacid 24HR.
— Zegerid OTC.
Among recommended antacids, TUMS is approved by 60% of pharmacists surveyed, followed by Mylanta with 24%.
OTC Products for Nausea
Most anti-nausea medications are available by prescription only, says Dr. Sanam Razeghi, a gastroenterologist at Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania. However, there are a handful of OTC options that can be effective if you have nausea.
Most pharmacists surveyed — 54% — recommend Emetrol as an OTC remedy for nausea. The recommended dosage of Emetrol for adults and children age 12 and over is 15 to 30 milliliters, and 5 to 10 millilters for children between 2 and under 11 years old. The dosage should be repeated every 15 minutes. You shouldn’t take more than five doses in an hour without consulting with a doctor.
The top recommended anti-nausea OTC products include:
— Flents Cola Syrup.
OTC Products for Constipation
Constipation is common and can be caused by a lack of liquid in the GI tract, a diet insufficient in fiber or, on rare occasions, issues with the muscles of the colon or pelvis, says Dr. John Pandolfino, chief of gastroenterology at Northwestern Medicine in Chicago. “For constipation, MiraLAX is our first-line treatment,” he says. “It’s very effective, it’s safe and a very gentle kind of laxative.” Pandolfino cautions that if you’re also experiencing bloody stools, rectal bleeding or unexplained dramatic changes in bowel habits, you should contact your health care provider. Often, though, bouts of constipation can be managed with OTC products, he says.
Here are the top laxatives recommended by pharmacists in the Pharmacy Times survey:
By a wide margin, pharmacists in the survey recommend MiraLAX, which is favored by 65% of respondents. Dulcolax got 32% of the vote.
Here are the top recommended nonfiber laxatives:
— Phillips’ Milk of Magnesia.
Two products, Dulcolax and Senokot, recommended by 45% and 36% of pharmacists, respectively, are the highest-recommended stimulant laxatives, which include:
— Colace 2-IN-1.
OTC stool softener products can help soften stools, making bowel movements easier. The vast majority of pharmacists in the survey recommend two stool softener products, Colace (79%) and Dulcolax (15%). Pharmacists who participated in the survey recommend these stool softener products:
— Phillips’ Stool Softener.
OTC Products for Diarrhea
Several OTC products, including Imodium, can be effective in treating diarrhea, Pandolfino says. However, if you’re suffering from severe dehydration, fever and have blood in your stool in addition to diarrhea, you should see your doctor, he advises. To treat diarrhea, Imodium is recommended by 91% of pharmacists surveyed. Here are the anti-diarrhea medications recommended:
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Update 03/25/21: This article was previously published and has been updated with new information.