Acid reflux is a very common condition and is also called ‘heartburn', gastroesophageal reflux disease, or GERD. The symptoms can be very bothersome. It can cause a burning in the chest when lying down after eating or after eating certain foods, or you may feel a small amount of acid/vomit traveling from your stomach to your mouth or to the back of your throat.

It's caused when the muscle that's supposed to hold stomach acid down isn't strong enough and some acid goes up the esophagus (the tube that connects the mouth to the stomach).

Yes. There's lots of research that shows that doctors or nurse practitioners can diagnose acid reflux based on your symptoms. In this sense we diagnose you exactly the same way we would if we met you in person.

We help you by finding the lowest dose of medicine that controls your symptoms. We do this by understanding whether you've ever been diagnosed before, what medicines you've tried and how these medicines have controlled your symptoms, and then we recommend a particular medicine at a particular dose.

If this medicine doesn't control your symptoms then you can come back to us and we'll see if it's appropriate to increase the dose or change you to a different medicine.

We can prescribe 2 different types of medicines if we're confident that you have acid reflux. They both reduce the acid levels of your stomach but work in slightly different ways. One group is called proton pump inhibitors (PPI) and the other is called H2 blockers (H2B).

The exact medicine we'll give you depends on everything we learn about you and what medicines you've tried before. If the first medicine we give you doesn't control your symptoms then we can normally either increase the dose of the same medicine or switch you to a different medicine. Overall our goal is to find the lowest effective dose of the right medicine that will keep your symptoms under control.

We usually prescribe a 1-month course of treatment if we're giving you a trial of a new medicine or a new dose.

When you tell us that your symptoms are under control then we typically give you a 3-month course of treatment.

We're able to prescribe certain types of medicines and doses that are not available over-the-counter. The medicines we prescribe are very effective at preventing acid reflux from occurring, unlike antacids which provide only temporary relief. The types of medicines we prescribe, PPI and H2B, have some versions that are available over-the-counter.

Most of the medicines we prescribe for have low cost generic versions. Many pharmacies offer them as part of special programs that can make them even less expensive. We can help you find the lowest cost option. If you're using the service for a refill of a medicine you're already taking that's expensive, we may be able to help you find a lower cost alternative that's just as effective.

The medicines we prescribe are used to prevent the symptoms of acid reflux from occurring. Some people need to take the medicines every day on an ongoing basis in order to prevent the symptoms from coming back. Other people are able to gradually wean themselves down to taking medicines only when they think they're going to have symptoms. Others stop taking the medicines altogether. We do our best to help you get your symptoms under control, and then we help you find the lowest strength effective dose.

Don't worry if the medicine we give you doesn't control your symptoms after a month. This is very common because we'll start you on the lowest dose that we think can still be effective given what you've told us. At the end of the month you can come back for a follow-up visit and we'll see if we can move you to a stronger dose or to a different medicine.

If you're already on the highest dose medicine we can prescribe, we'll encourage you to see a doctor or nurse practitioner in person to discuss your treatment options.

If you experience symptoms of acid reflux 3 or more times a week then we think you should see a doctor or nurse practitioner in person and not use our service.

Similarly, if you’re already on the maximum dose that we can prescribe, then we’ll ask you to see a doctor or nurse practitioner in person. Other health conditions and symptoms make it important that you see a doctor or nurse practitioner in person, and we’ll tell you about these health conditions as part of our visit.

Even though we know we can make the right diagnosis in the vast majority of cases, it's important that you understand the risks of using our service.

Usually when you're diagnosed in person the diagnosis is based mostly on your symptoms, which is the same as we do. If your symptoms keep bothering you and aren't controlled you should go for a test called an endoscopy that actually looks in your esophagus and stomach.

If we diagnose you with acid reflux and you don't actually have acid reflux, then the medicine we give you could be unnecessary. Taking a medicine you don't need could cause harm from the possible side effects. It could also delay the time it would take for you to be diagnosed with a different underlying problem that could be the real source of your symptoms.

If you actually have acid reflux and we incorrectly decide that you don't have acid reflux there's a risk that it would delay your care. Whenever we tell someone that we can't help, we'll always give you clear instructions to go see a doctor or nurse practitioner in person.

There are some factors you can control for acid reflux and others that are out of your control. There are some simple things that are good for your general health that can help reduce symptoms in most people like losing weight if you're overweight, quitting smoking if you smoke, and avoiding sugary drinks and foods. You can also try avoiding caffeine, alcohol, or spicy foods, which can sometimes worsen your symptoms.

When your symptoms are well controlled we recommend a ‘discontinuation trial’. A discontinuation trial is exactly as what it sounds like. You decrease or stop your medicine to see if your symptoms return. This way we can make sure you are always on the lowest effective dose of medicine or no medicine if you don't need it anymore.

The medicines we use to treat acid reflux can be very effective. In fact, they’re often so effective that after a while it’s hard to tell if you even need to take them anymore. To be sure you really need to keep taking the medicine we advise all our patients to do a discontinuation trial at least once.