Acid reflux: when a PPI makes sense — and when not to self-treat

Heartburn is a burning sensation behind the breastbone, often after eating or when lying down. Acid may rise into the throat and leave a sour taste. Large meals, alcohol, smoking, excess weight and some medicines can make symptoms worse, but triggers vary.

Occasional mild symptoms may respond to meal timing, smaller portions, avoiding a personal trigger and pharmacy advice. Repeated symptoms deserve review because indigestion, ulcers, medicine side effects and heart problems can sometimes feel similar.

Proton-pump inhibitors, including omeprazole and lansoprazole, reduce how much acid the stomach makes. NHS guidance notes that a clinician may use a four- or eight-week course depending on symptom severity. The medicine must be taken as directed; it is not an instant antacid.

If symptoms return after a course, do not simply keep restarting indefinitely. A review can check whether the diagnosis is right, whether another medicine contributes, and whether testing for Helicobacter pylori or a specialist assessment is needed.

Ask for urgent medical advice if food sticks or swallowing is painful, you vomit blood, pass black stools, have persistent vomiting, unexplained weight loss, anaemia or a new persistent symptom pattern. Call 999 for severe chest pain, especially with breathlessness, sweating or pain spreading to the arm, jaw or back.

Long-term PPI treatment can be appropriate for some conditions, but it should have a clear indication and periodic review. Always mention all prescribed and non-prescribed medicines during an assessment.