Ajax Harwood Clinic
Acid reflux and heartburn
Reflux is stomach acid coming back up into the gullet, causing burning behind the breastbone, an acid taste, or a cough — because the valve at the top of the stomach is not sealing as it should.
Get help straight away if
These are uncommon, but they need same-day care — go to an emergency department, do not wait for an appointment.
- Chest pain with sweating, breathlessness, or pain spreading to the arm, neck or jawHeart attacks are regularly mistaken for indigestion. Call 911 — do not treat this as reflux and wait.
- Vomiting blood, or black tarry stoolsGo to an emergency department.
Contact us promptly if
Not an emergency, but worth being seen sooner rather than waiting it out.
- Food sticking on the way down, or pain on swallowingNeeds assessment rather than stronger acid treatment.
- Losing weight without trying
- New reflux symptoms starting after the age of 50
- Symptoms that keep coming back despite proper treatment
What usually happens
Most reflux is exactly what it seems and settles with treatment. The features above matter because they are the ones that mean it might be something else — which is worth knowing rather than worrying about.
Timing of the tablet matters more than people realise. Acid-suppressing medication generally works best taken before a meal rather than at bedtime or when symptoms strike, and taken wrongly it can seem not to work.
The habits that help are unglamorous and effective: not lying down within a few hours of eating, raising the head of the bed, and identifying your own trigger foods rather than avoiding a generic list.
Long-term acid suppression is sometimes right and sometimes worth stepping down. Either way it is a decision to revisit, not a prescription to renew indefinitely without review.
At your appointment
We will ask what the symptoms are, when they happen, what you have tried, and — specifically — when in the day you take it.
We will check for the features above, since those decide whether this is treated or investigated.
Most people are treated without a scope. Endoscopy is for alarm features, persistent symptoms despite treatment, or particular risk factors.
If treatment works we will discuss how long to stay on it and whether stepping down is reasonable.
Worth asking
- When exactly should I take this in relation to meals?
- Do any of my other medications make reflux worse?
- How long should I stay on this, and can I step down?
- What would make you want to arrange a scope?
Curious what your doctor is weighing up? The clinical tool we use for gerd is open to anyone — it is detailed and written for clinicians, and you are welcome to read it.
Open the clinician reference →General health information for Ajax Harwood Clinic patients and the public — not medical advice, and not a substitute for seeing your own doctor. In an emergency call 911.