<b><i>Background:</i></b> Dyspepsia and heartburn are extremely common conditions, thus a search for safe and effective treatment alternatives is justified. <b><i>Objectives:</i></b> To demonstrate the noninferiority of Gastricumeel (Ga6) in terms of effectiveness and safety to proton pump inhibitors (PPIs) in the treatment of patients with dyspepsia and/or heartburn. <b><i>Methods:</i></b> Prospective, comparative, observational cohort study. Patients with dyspepsia or heartburn were treated

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... ther with Ga6 or with PPIs as monotherapy during approximately 6 weeks. The intensity of eight symptoms was assessed as well as overall condition, treatment compliance and tolerability, and any adverse drug reactions. Adjustment for covariates was done via the calculation of propensity scores in logistic regression. <b><i>Results:</i></b> A total of 640 patients (447 Ga6, 193 PPIs) from 48 German general practices participated. More than half the patients had suspected acute gastritis and around 40% of patients had heartburn. Adjusted between-treatment difference scores of changes in the intensity of the eight assessed symptoms were within the bounds for noninferiority of Ga6 compared to PPIs. Effectiveness ratings were comparable; compliance and tolerability were rated better in the Ga6 group. <b><i>Conclusion:</i></b> It is worth considering Ga6 as a safe and effective treatment option in the management of dyspepsia and heartburn.