Get checked promptly if you have
- Trouble swallowing, or food that feels stuck
- Pain when swallowing
- Weight loss you can't explain
- Repeated vomiting
- Black stools, vomiting blood or iron-deficiency anemia
Chest pain deserves a heart evaluation first. Once your heart is cleared, reflux is a common cause.
When medicine isn't working
A proton pump inhibitor (PPI) such as omeprazole works best taken 30 to 60 minutes before breakfast. If your symptoms continue after about 8 weeks of taking it correctly, or come back every time you stop it, an evaluation is the next step rather than another refill.
Screening for Barrett's esophagus
Even well-controlled reflux can warrant a one-time endoscopy. The American College of Gastroenterology suggests screening for people with long-standing reflux and three or more of these risk factors: male sex, age over 50, white race, a history of smoking, obesity, or a family history of Barrett's esophagus or esophageal cancer. More on Barrett's esophagus.
What the scope looks for
An upper endoscopy takes about 10 to 15 minutes under sedation. It can show inflammation of the esophagus (esophagitis), Barrett's esophagus, a hiatal hernia, narrowing (a stricture) or eosinophilic esophagitis, an allergic condition that mimics reflux. If the scope looks normal but symptoms continue, a wireless pH test can confirm whether acid is really the cause.
Heartburn is common, and usually manageable. The goal is to catch the few cases that need a closer look.
— Brian Frank, MD
Questions about reflux? Call (813) 400-0543 or send a message.
Board-certified gastroenterologist (ABIM). Published October 8, 2026.
This page is general information, not medical advice. For a medical emergency, call 911.