Fact sheet

Reflux and Heartburn

Stomach acid creeping up into the oesophagus, causing burning behind the breastbone or a sour taste. Very common, very treatable, and often fixable with a few habit changes.

The reflux ladder

Habits first, tablets second. Climb as far as you need, then step back down to the lowest thing that works.

  1. Step 1 · Self-careChange the timing, not your whole lifeSmaller meals, nothing for 2–3 hours before bed, raise the head of the bed, and lose weight if you’re above a healthy weight.
    Works
    Small trials only; weight loss and raising the bedhead have the best evidence. Many need nothing more
    Cost
    Free (maybe some bed blocks)
    How long
    Ongoing
    Watch for
    Only cut foods that are your triggers. There’s no need to give up everything on the internet’s list.

    Lying flat after a midnight kebab is gravity’s favourite joke.

  2. Step 2 · PharmacyAntacids and alginatesLiquids or chewables that neutralise acid or form a raft on top of the stomach contents.
    Works
    Alginates: about 4 times the odds of relief vs a dummy treatment or antacid; works in minutes, but short-lived
    Cost
    About $10–20
    How long
    As needed
    Watch for
    Needing them most days? Time to climb. Some contain lots of sodium or calcium.

    Great fire extinguisher. Terrible fire prevention plan.

  3. Step 3 · PharmacyAcid-reducing tablets (famotidine, or a short course of a pharmacy PPI)Turn down acid production. Pharmacy PPIs come in 14-day packs.
    Works
    Famotidine: modest (about 20% fewer with ongoing heartburn than a dummy treatment); a pharmacy PPI works better
    Cost
    About $10–20 a pack
    How long
    Up to 14 days; see your GP if you need more
    Watch for
    If symptoms come straight back when you stop, get checked rather than buying another box.

    Fourteen days means fourteen days, not fourteen packs.

  4. Step 4 · PrescriptionProton pump inhibitor (PPI) tablets (esomeprazole, pantoprazole, omeprazole, rabeprazole)Daily for 4–8 weeks, then step down to the lowest dose or as-needed.
    Works
    Ongoing heartburn about 60% less than a dummy treatment; heal inflamed oesophagus in about 8 in 10 within 8 weeks
    Cost
    Under the $25 PBS co-payment, about $20–25 a month
    How long
    4–8 weeks, then review
    Watch for
    Headache, diarrhoea. Long-term use is linked to low magnesium and B12 and gut infections. Stopping suddenly can cause rebound burning.

    Take it 30 minutes before breakfast. With the bacon is too late.

  5. Step 5 · SpecialistGastroscopy (camera test)A specialist looks at the oesophagus and stomach, usually as a day procedure.
    Works
    A test, not a treatment: finds or rules out ulcers, inflammation, Barrett’s oesophagus and cancer
    Cost
    Free in public hospitals (waits apply) or private with an out-of-pocket gap
    How long
    One test, sometimes repeated over years
    Watch for
    Needed for warning signs (below), symptoms that don’t respond, or long-standing reflux.

    Dr Google can’t see your oesophagus. A camera can.

  6. Step 6 · ProcedureAnti-reflux surgery (fundoplication)The top of the stomach is wrapped around the lower oesophagus to tighten the valve.
    Works
    About 85–90% still in remission at 5 years, similar to long-term tablets, in carefully chosen people
    Cost
    Free in the public system (expect a wait); private out-of-pocket costs often run to thousands
    How long
    One operation; weeks to recover
    Watch for
    Trouble swallowing, bloating, and difficulty burping or vomiting.

    A big fix for a small number of people. Not a shortcut past the basics.

Costs are rough Australian prices in October 2026 and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

What you can do

See your GP if

See a doctor promptly if food sticks or it hurts to swallow, you’re losing weight without trying, keep vomiting, or are pale and tired (anaemia).

Heart attacks can feel like heartburn. For chest pain that is heavy or tight, spreads to the arm, jaw or back, or comes with breathlessness or sweating, or if you vomit blood or pass black poo, call 000 (Australia) or your local emergency number. From a mobile, 112 works in most countries.

Common questions

What foods should I avoid with reflux?

Only the ones that trigger your symptoms. Common culprits are big fatty meals, alcohol, coffee, chocolate, spicy food and citrus, but they don’t affect everyone. Meal size and timing matter more.

Are PPIs safe long term?

For people who need them, mostly yes. They’re linked to some long-term risks, so the aim is the lowest dose that controls symptoms, and a regular check that you still need it.

How do I stop taking a PPI?

Step down gradually: halve the dose or take it every second day for a few weeks, using antacids for breakthrough symptoms. Stopping suddenly can cause a few weeks of rebound burning.

Is reflux in pregnancy normal?

Very common, especially later in pregnancy. Lifestyle changes and antacids or alginates are first choice; your doctor or pharmacist can advise on tablets.

Helpful resources

Evidence and more information

Reviewed 28 October 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

Related

maladywise.com/reflux/