No warning symptoms
Lifestyle measures and a clinician-guided, time-limited medication trial may be appropriate, followed by review.
Ask Us · The Heartburn & Reflux Health Hub
Heartburn or Acid Reflux —
Should You Be Worried?
Is it just occasional heartburn, or is your oesophagus trying to tell you something?
Occasional symptoms are common. Frequent reflux, disrupted sleep or symptoms continuing despite medication deserve a closer look.
Understand Your Reflux ↓
Do not wait for this guide if you need urgent help. Vomiting blood or black, tarry stools needs urgent medical attention. Call 999 or go to A&E if you are also unwell, faint, dizzy or have abdominal pain. For swallowing difficulty or food sticking, request an urgent GP appointment or contact NHS 111. New severe chest pain, especially with sweating or breathlessness, needs emergency help.
Educational symptom explorer · Adults
Your Reflux Guide
Four questions to explain possible next steps. This is not a diagnosis or a test of your cancer risk. Answers stay in this page and are not sent or saved.
Clear answers, at your pace
Your reflux questions, explained.
What is heartburn, and why does acid reflux happen?
Heartburn is a burning feeling behind the breastbone. Reflux happens when stomach contents flow back into the oesophagus (food pipe).
Learn more
Symptoms may follow meals or occur when lying down. Repeated troublesome reflux may be called gastro-oesophageal reflux disease (GORD). Chest discomfort can have other causes: sudden chest pain with breathlessness, sweating or pain spreading to the arm or jaw needs emergency help.
Is my heartburn harmless, or should I be concerned?
Occasional symptoms are common, but frequent symptoms, disturbed sleep or warning symptoms deserve medical review.
Learn more
Ask for an urgent GP appointment or contact NHS 111 for swallowing difficulty or food sticking. Unexplained weight loss, repeated vomiting or anaemia also need prompt assessment. Vomiting blood or black, tarry stools need urgent medical attention. This guide cannot rule out serious illness.
Is it safe to take omeprazole or lansoprazole every day?
Daily PPIs are appropriate for some conditions. Their ongoing need and dose should be reviewed with your prescriber.
Learn more
These medicines reduce acid production. Some people need long-term treatment, while others may be able to reduce treatment after review. Do not stop, increase or change prescribed medication based on this guide. Discuss benefits, potential risks and the lowest effective dose with your clinician.
Do I need a gastroscopy? When is it necessary?
Not everyone with heartburn needs a gastroscopy. Your clinician considers warning symptoms, previous treatment and your individual risk.
Learn more
A gastroscopy examines the oesophagus, stomach and first part of the small bowel with a flexible camera. It can identify inflammation, narrowing or other changes and allow biopsies when needed. Benefits, risks, alternatives and preparation should be discussed before consent.
What if my gastroscopy is normal but I still have reflux?
A normal gastroscopy does not necessarily exclude reflux. Further assessment may clarify what is causing persistent symptoms.
Learn more
Possible explanations include reflux without visible inflammation, sensitivity to reflux or symptoms unrelated to reflux. Ambulatory reflux monitoring may help distinguish these patterns. Further tests depend on your history and previous findings; they are not automatically needed.
When do I need pH impedance testing or oesophageal manometry?
These tests answer different questions and are selected after clinical assessment.
Learn more
pH impedance monitoring measures acid and non-acid reflux and its relationship to symptoms. Manometry measures the movement and pressure of the food pipe; it does not directly measure acid reflux. Testing may help with persistent symptoms, diagnostic uncertainty, swallowing problems or planning selected anti-reflux treatments. Your team decides whether testing is performed on or off medication; do not stop medication yourself.
Are antacids and PPIs the same?
No. Antacids neutralise acid already present; PPIs reduce how much acid your stomach produces.
Learn more
Alginates form a protective barrier that can reduce reflux symptoms. These medicines have different roles and interactions. A pharmacist or clinician can advise on appropriate use.
Does H. pylori cause acid reflux?
H. pylori is a stomach infection associated with ulcers and indigestion. Reflux symptoms alone do not establish that you have this infection.
Learn more
Your clinician may consider testing depending on your symptoms and history. Treatment for H. pylori and management of GORD are different decisions. Follow the testing service’s medication instructions.
Investigations, explained
The right assessment. The right next step.
Heartburn or acid reflux
Clinical assessment, medication review and warning symptom screening
Clinical assessment, medication review and warning symptom screening
Prompt medical assessment
Urgency and possible gastroscopy are determined by symptoms and clinical findings.
Clarify the diagnosis
Selected patients may need gastroscopy and/or reflux monitoring. Manometry answers specific questions about swallowing and oesophageal movement.
Personalised treatment plan
Medication review, appropriate tests or anti-reflux treatment for selected patients
Medication review, appropriate tests or anti-reflux treatment for selected patients
Understand your options.
Not every episode of heartburn needs an endoscopy. Not everyone with reflux needs lifelong medication. The right diagnosis helps guide the right treatment.
Discuss a consultation →Sources & further reading
Educational draft prepared 31 October 2026. Clinical review by GastroClinics is pending. No automated result replaces individual assessment.
NICE: GORD and dyspepsia · NHS: Heartburn and reflux · NHS: Swallowing problems · NHS: Vomiting blood · AGA: Personalised reflux assessment