Part of HIV & You: Managing Gut Symptoms

Managing Gut Symptoms

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Some common causes of heartburn are:

  • Alcohol
  • Certain foods such as chocolate; coffee; cola and other carbonated drinks; acidic or sugary food and drink (specifically, citrus fruits and juices); foods containing tomatoes, including spaghetti sauce and ketchup; fried, fatty and spicy foods; garlic and onions; mint; mustard; and vinegar
  • Certain medications
  • Eating large meals
  • Too much exercise (especially after eating)
  • Being overweight
  • Pregnancy
  • Smoking
  • Stress
  • Wearing tight clothes
  • Bearing down hard when you go to the bathroom

Other diseases may cause heartburn as well, including pancreatitis and H. pylori infection.


They might be the cause -- especially regimens containing Norvir. Other medications may cause heartburn, such as aspirin and many pain medications; certain antibiotics; certain medications for allergies, anxiety or erectile dysfunction; calcium blockers; cancer treatments and corticosteroids; and certain supplements (including iron, potassium and vitamin C).

About 10% of adults get heartburn (aka indigestion or reflux) at least once a week, but when it is severe, it can be dangerous.


Heartburn is a burning, sour feeling in your mid-chest. Known as acid reflux or GERD, it may come and go, and can last from a few minutes to a few hours.

Food travels down the esophagus, which leads from your mouth to your stomach. At your stomach, a valve opens up to let the food through, and then closes so your stomach can digest it. Your stomach mixes some pretty strong acids with the food to help break it down. Sometimes, the valve doesn't shut properly, and the acids in your stomach back up into your esophagus. This is known as heartburn because the sensation is in the area near your heart.


Acid-reducing medications (also called antacids), such as Alka-Seltzer, Maalox and Rolaids, can help. But if you are currently taking HIV meds, talk to your doctor or pharmacist before taking them. These medications may weaken the ability of some HIV meds to fight the virus, especially Aptivus, Complera, Edurant, Reyataz, Stribild and Videx EC.


University of Minnesota School of Medicine

Treatment Tips: "I initially try antacid tablets such as Tums, followed by an acid-reducing drug such as ranitidine, cimetidine or famotidine, especially at night. Raising the head of the bed can help. If symptoms persist, I look for contributing problems (taking aspirin, ibuprofen, caffeine, alcohol, spicy foods, late-night snacking) and health conditions (such as peptic ulcer disease or H. pylori infection). I may refer patients to a gastrointestinal doc for further evaluation."

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How your doctor should help you

Usually, heartburn is minor and doesn't last long. But if it becomes a burden or affects your quality of life, call your health care provider. Heartburn is often easy to treat, but if left untreated, it has the potential to cause more severe health problems over time.

Talk to your doctor or call an ambulance immediately if your heartburn is especially severe or comes with any of the following symptoms:

  • Difficulty swallowing or breathing
  • Severe tightness or squeezing in your chest
  • Unusual pain in your stomach or chest area, especially if any acid-reducing medications already recommended by your doctor or pharmacist don't get rid of it
  • Vomiting, especially if it has blood in it