Choosing Wisely - Heartburn and reflux

Do you need a medicine?

Acid reflux – also described as heartburn – is a condition where acid from the stomach moves up into your oesophagus (food pipe). Acid reflux is very common. Many people can control their symptoms by making lifestyle changes or by taking over-the-counter (non-prescription) medicines as needed. Some people with more regular or severe symptoms – people with gastro-oesophageal reflux disease (GORD) – may need a prescription medicine known as a proton pump inhibitor (PPI). PPI medicines work by reducing the amount of acid made by the stomach and are very effective at controlling symptoms of reflux and heartburn. However, PPIs should not be taken long term when not needed, because of the cost and possible side effects.

If you’ve been taking a PPI for more than 4 to 8 weeks, and your symptoms seem to be well managed, talk to your health professional about reviewing your medicine. Your health professional may recommend “stepping down” your treatment, which can include any of the following:

• reduce your daily dose of medicine
• limit your treatment so that you take medicine only when you experience the symptoms of heartburn and reflux (also known as on-demand therapy)
• stop treatment completely as your symptoms may not return.

What can you do?

Making changes to your lifestyle may help control your symptoms and reduce the need for medicine.

• Stop smoking. Discuss ways to quit smoking with your health professional, such as nicotine replacement therapies, or call the Quitline on 0800 778 778.

• Identify and avoid foods and drinks that make your symptoms worse (e.g. fatty foods, spicy foods, chocolate, coffee, cola drinks, orange juice and alcohol).

• Avoid eating large or late meals and avoid lying down immediately after meals.

• If you experience symptoms that are worse at night and disrupt your sleep, try raising the head of your bed.

• If you are overweight, try losing some weight.

It’s OK to ask questions
If you have questions about your symptoms or the medicines managing your symptoms, speak with your health professional.

You can also download this information as a pdf (325 KB).

Adapted from NPS MedicineWise (2016), Heartburn and reflux. Reasonable care is taken to provide accurate information at the time of creation. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. NPS MedicineWise and Choosing Wisely New Zealand do not assume any responsibility or liability arising from any error or omission or from reliance on any information in this resource.