What Should I Take for Heartburn: Tums vs. Pepto-Bismol

Tums and Pepto-Bismol are both popular over-the-counter medications. They share a common goal: to provide relief from various digestive discomforts. Both products can offer some level of relief from heartburn or acid reflux.

Tums works by neutralizing excess stomach acid, providing relief from heartburn and related symptoms. Pepto-Bismol has a broader range of actions, including antimicrobial properties to combat some types of diarrhea, particularly traveler's diarrhea. It also helps prevent fluid loss and provides some level of stomach soothing.

Tums

• Heartburn
• Sour stomach
• Acid indigestion

Pepto-Bismol

• Diarrhea
• Traveler's diarrhea
• Overindulgence of food and drink (heartburn: to a lesser extent than Tums, nausea, gas)

How to Take It (Adults): Tums

• Take 1-4 tablets as soon as symptoms occur.
• Relief: Expect relief within minutes. Relief can last from 30 minutes to a few hours.
• Maximum dose depends on the prodcut. Do not use Tums for more than 2 weeks without consulting a doctor. If symptoms last longer than 2 weeks, see a doctor for proper diagnosis and treatment.

How to Take It (Adults): Pepto-Bismol

• Chew (caplets) or Swallow (liquid): 2 caplets or 2 tablespoons.
• Frequency: Take every 30 minutes as needed. Do not use for more than 2 days without consulting a doctor.
• Relief: Expect relief from heartburn, indigestion, nausea, and diarrhea.
• Daily limit: 16 caplets or 8 doses of liquid.

Importantly, neither product is intended for long-term use. Tums is generally not recommended for more than 2 weeks, and Pepto-Bismol should not be used for more than 2 days without consulting a healthcare professional.

How They Work

Tums

Calcium carbonate, the main ingredient in Tums, works to combat acid reflux. When this medication enters the stomach, it quickly neutralizes stomach acid. Tums act almost immediately, and their effects may last for up to a few hours.

This is extremely effective for quick relief of occasional heartburn. However, if you are finding you feel the need to use antacids like Tums all the time, there are other medications that are more appropriate for long-term relief of chronic heartburn (also known as gastroesophageal reflux disease).

Pepto-Bismol

Pepto-Bismol contains a special ingredient called bismuth subsalicylate. In your body, this breaks down into two parts:

• Bismuth: This part stays mainly in your digestive system and turns into salts.
  • Antimicrobial Action: These salts can kill or inhibit the growth of certain bacteria, particularly helpful for traveler's diarrhea.
  • Fluid Reabsorption: They aid in the reabsorption of fluids and electrolytes that may be lost due to diarrhea, helping prevent dehydration.
  • Protective Coating: They can form a protective coating on the lining of the stomach and intestines, soothing irritation.
• Salicylic acid: Has anti-inflammatory properties and can also help slow down the movement of food through the intestines, allowing for better absorption of fluids.

Side Effects

Both Tums and Pepto-Bismol are considered safe with minimal side effects. These side effects are different for the two medications, which should be considered before making the choice for either option.

Tums

Tums are thought of as a very safe medication. There are some common but mild side effects, especially when used often or in large amounts.

• Burping
• Constipation
• Gas

Pepto-Bismol

Side effects with the use of Pepto-Bismol are uncommon and typically mild. The most common side effects include:

• Better baste
• Temporary darkening of stool

Rare but serious side effects of Pepto-Bismol

• Ringing in the ears
• Worsening diarrhea

If you experience any unpleasant or unwanted side effects while using either product, stop taking it and seek advice from a healthcare provider.

Warnings

Both Tums and Pepto-Bismol are considered very safe for most people. However, like any medication, they are both associated with various risks, which vary significantly between the two products.

Tums

Although Tums are considered to be a very safe medication, there are some potential risks that should be taken into consideration before use.

• Hypercalcemia (high calcium levels) if taken for an extended period of time. If you are taking Tums all the time, calcium can add up. Too much calcium can be associated with severe health risks such as calcium deposits in the blood vessels or organs, and can be dangerous in individuals with chronic kidney disease.
• Drug interactions due to calcium as the main ingredient. . Calcium can bind to certain medications, preventing them from being absorbed into the body. The list of medications is long, including:
  • Levothyroxine
  • Certain antibiotics (ie: tetracyclines)
  • Iron supplements
  • Some antifungal medications

Take Tums at least 1 hour before and 4 hours after your other medications to minimize the potential changes to medication absorption. It is also important to check with a healthcare provider before using Tums to see if they are safe to use alongside with your medications.

Pepto-Bismol

Pepto-Bismol is safe to take from time to time. However, there are some groups of people in which the medication may have additional risks. The groups of individuals who should avoid using Pepto-Bismol altogether include:

• Anyone with a known allergy to salicylates (including aspirin)
• Children/teens who currently have or are recovering from chicken pox or other flu-like illnesses.
  This is due to the risk of salicylates causing Reye’s syndrome, which is very rare but can be serious. If you experience nausea or vomiting while using Pepto-Bismol, it is important to seek advice from a healthcare provider.

Cost

As over the counter products, both Tums and Pepto-Bismol can be purchased at any regular pharmacy without the need for a prescription. Both products come in a variety of formulations, such as chewable tablets and gummies, although Pepto-Bismol comes in additional forms including capsules and liquid suspension.

Different formulations and pack sizes have various price points. In general, most products can be purchased for under $15, although Tums products tend to come in larger pack sizes for a slightly lower price point.

Overall, both medications are low-cost options to help manage short-term digestive troubles.