It isn’t, and the FDA wants you to know that.

Although both are available over the counter, they are intended to treat different medical conditions.  Maalox Total Relief contains bismuth subsalicylate, which is related to aspirin and can cause bleeding and other serious side effects.

Maalox Total Relief treats upset stomach and diarrhea, while liquid Maalox Maalox Advanced Regular Strength and Maalox Advanced Maximum Strength are antacids for conditions such as heartburn.

People with bleeding disorders or gastrointestinal ulcers should not use Maalox Total Relief, nor should patients taking certain medicines that interact with aspirin including oral antidiabetic drugs, blood thinning drugs (anticoagulants) such as warfarin (Coumadin) or clopidogrel (Plavix), non-steroidal anti-inflammatory drugs (NSAIDS), and other anti-inflammatory drugs.

Maalox Total Relief  shouldn’t be given to children or teens with fever, flu, or chicken pox since salicylates can sometimes cause Reyes Syndrome, a potentially fatal condition, in children and teens with viral infections.

The FDA tells consumers to:

• Check with their health care professional if they have any question about which Maalox product is right for them.
• Look carefully at the label to be sure that they are buying the right Maalox product.
• Read the active ingredients and any drug warnings in the “Drug Facts” box before purchasing any Maalox product.
• Report any serious side effects from using a Maalox product to the FDA Medwatch Program. FDA Medwatch can be reached at 1-800-332-1088.

Cancer patients should always discuss any medicine or dietary supplement with their doctor before taking it to be sure that it is safe and will not interfere with cancer treatment.

Patients who ever had severe heartburn or women who are pregnant know how bad this pain can be. If you have heartburn for the first time, you may end up in the emergency room because it is such a burning chest pain that is can look like a heart attack. In fact, one of the differential diagnoses of chest pain is heartburn.

Most of time the burning is caused by acid reflux from the stomach irritating the lining of the esophagus. Most physicians start with Maalox or Pepcid over the counter, but in severe cases you may need higher doses of prescription drugs such as Prevacid, Prilosec or Aciphex which inhibit acid production even more strongly.

However if the heartburn persists despite treatment for more than two weeks, you need to be seen by your physician and be evaluated with an endoscopy looking into your stomach to make sure you don’t have an ulcer which is not healing up, possibly caused by H. Pylori (an infection which requires antibiotics), hiatal hernia (when the stomach travels partly into the chest), or changes like Barretts in the lower third of the esophagus. All these conditions trigger specific therapies or screening.

Sometimes it is not acid burning the lining but it may be bile going from the stomach into the esophagus, particularly for patients who underwent stomach surgery.

We also need to be aware that stopping acid will change our whole digestive system. Acid is important for digesting our food. Certain enzymes which break down our food work the best in acid conditions, and acid can help to kill bacteria. Taking all acid away for a long time can lead to indigestion, gas, cramping, loose stools, and not completely digesting food.

We know that diet is the major contributor of heartburn. Heavy meals late in the evening or night can easily cause heartburn because stomach acid is pushed back into the esophagus (eating pipe) which is located behind your chest. If acid hits these sensitive tissues it can cause inflammation (esophagitis) which you feel like it is burning. Refined sugar can cause severe heartburn, as does caffeine, alcohol and spicy foods.

Some patients don’t get any relief from antacids but from carafate which is a protecting film which lies on the irritated lining to allow healing and protect against bile coming up from the small bowel into the stomach and lower esophagus.

There are a lot of homemade remedies to deal with symptoms of heartburn. Some say drinking milk helps them very effectively. Others say almonds can help, and, most recently, I read in the Los Angeles Times that bananas do. Some patients report that eating bananas helped their nightly heartburn every time they experienced it. Digging deeper into that, I found that in India doctors prescribe bananas or banana powder to treat stomach upset or indigestion. In 1990 there was a paper published in The Lancet which showed that banana powder reduces indigestion in 75% of patients. It may be worthwhile to try.

The reason that is there is not one relief is because heartburn can be caused by so many different reasons which make it impossible to find ONE CURE. Interestingly, I also found is that chamomile tea is very good for stomatitis and ulcer, but you need to avoid peppermint. Even breath mints can cause more severe heartburn since peppermint has been shown to open up the “door” between stomach and esophagus.

A report that persimmon punch helps reflux came from a woman who sampled it in a Korean restaurant. I found the following recipe for persimmon punch: Combine 2 quarts of water, ½ cup of thinly sliced fresh ginger and 3 cinnamon sticks. Simmer for ½ hour. Strain the liquid and stir in 1 and ½ cup sugar and 1 cup of sliced dried persimmons. Chill in the refrigerator overnight and serve cold.

Another remedy is ginger which has a long-standing reputation for soothing stomach disorders. It has been used by Chinese sailors for motion sickness for at least a thousand years, and many readers have found it helpful for upset stomach. In Europe fennel seeds have been used for centuries for gas and abdominal bloating. Recently there are reports that a teaspoon after meals protects against heartburn. Fennel has traditionally been used to treat indigestion and gas. It has been shown to counteract smooth muscle spasms in the digestive tract.