A Cochrane review included 3 studies with a total of 286 subjects. A calcium based antacid plus ranitidine relieved heartburn better than antacid alone (mean difference (MD) at one week -0.31, 95% CI -1.89 to 1.27; MD at two weeks -2.13, 95% CI -4.37 to 0.11; 1 trial, n=30). In another study magnesium and aluminium based antacid with simethicone relieved symptoms better than placebo (RR 1.41, 95% CI 1.18 to 1.68; 1trial, n=156). Also 1 trial carried out almost 50 years ago had positive findings of a treatment rarely used nowadays (prostigmine). There is little information on the safety of these drugs.
Another Cochrane review included 4 studies with a total of 358 subjects. More women in the sucralfate group (1g of sucralfate with advice on dietary and lifestyle choices) experienced complete relief of heartburn compared to women who received advice on diet and lifestyle choices (RR 2.41, 95% CI 1.42 to 4.07; 1 trial, n=65).
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), by inconsistency (heterogeneity in interventions and outcomes) and, by imprecise results (few patients and wide confidence intervals).