Surgeon's 'making it worse' warning for people taking omeprazole or lansoprazole

Surgeon's 'making it worse' warning for people taking omeprazole or lansoprazole They are among the most commonly prescribed drugs in the country and are available over the counter A surgeon has issued a warning for anyone taking common heartburn medicines like omeprazole. General surgeon Dr Ali Cadili says you could be making yourself ill. An estimated 15% of the UK population - approximately 1 in 7 people - take omeprazole or similar stomach acid-reducing medications. The drugs, known as Proton Pump Inhibitors (PPIs), are among the most frequently dispensed medicines in the country. The NHS dispenses over 73 million prescriptions for PPIs annually in England alone, with omeprazole being the most common. Omeprazole and other PPIs (such as lansoprazole and esomeprazole) work by blocking the proton pumps in the stomach lining that produce acid. PPIs are used in the treatment of upper gastrointestinal disorders characterised by excessive acid production. As well as being prescribed, lower-strength versions are available to purchase over the counter at UK pharmacies and supermarkets. Dr Cadili said: "Heartburn meds can work extremely well, but the way many people self-treat can keep the stomach and oesophagus irritated and can trigger rebound symptoms that feel like the reflux is getting worse. The bigger problem is that this DIY cycle can also delay the right diagnosis, because you’re constantly turning down the acid instead of asking why you still need it. Most cases are straightforward reflux, but persistent or changing symptoms should always be taken seriously rather than simply masked." Acid-reflux medicine mistakes that can make health worse Taking PPIs at the wrong time Proton pump inhibitors (PPIs) like omeprazole and pantoprazole do not work like instant relief medicines. They need to be in your system before your stomach starts producing acid after eating. A common mistake is taking them only when symptoms appear, at random times of day, or after heartburn has already started. At that point, the medicine is too late to properly prevent acid production, so symptoms can break through anyway. In real life, this often happens when routines are inconsistent - skipping breakfast, taking the pill after coffee, or only using it when discomfort shows up. That leads people to think the medication isn’t working, when the real issue is timing, not effectiveness. Dr Cadili said: "Take PPIs consistently every day as directed, ideally 30 to 60 minutes before breakfast on an empty stomach. This gives the medication time to switch off acid production before food triggers it." Using antacids as daily maintenance Antacids work quickly, which makes them easy to overuse. People often turn them into a daily routine - keeping them at work, in the car, or by the bed and taking them whenever symptoms return. While they can temporarily calm heartburn, they don’t treat the underlying cause. The problem is that this pattern can hide worsening reflux. Instead of addressing why symptoms are happening more often, people keep layering quick fixes. Over time, it can make frequent reflux feel normal when it is not, and that can stop people from getting the right help. Dr Cadili said: "Use antacids only for short-term, occasional relief. If you need them more than twice a week, or if heartburn is affecting sleep or daily life, it’s a sign the situation needs reassessment rather than more frequent dosing." Stopping a PPI abruptly after long use Stopping PPIs suddenly after regular use can trigger rebound acid production. This means the stomach temporarily produces more acid than before, making symptoms feel worse even if things were improving overall. In practice, people often stop suddenly when they feel better, run out of medication, or worry they’ve been on it too long. The result is a sudden return of strong heartburn, which then leads them to restart the medication, sometimes at higher doses or alongside multiple over-the-counter products. This creates a stop-start cycle that never fully stabilises symptoms. Dr Cadili said: "Do not stop PPIs abruptly after regular use without guidance. If stopping is appropriate, a clinician can recommend a gradual step-down approach to reduce rebound symptoms and help the body adjust safely." Mixing medicines while keeping triggers Many people assume that if they are taking the right medication, they can continue habits that trigger reflux. But medications have limits if the underlying triggers remain in place. Common issues include eating large or fatty meals late at night, eating too close to bedtime, frequent snacking late in the evening, and alcohol use, all of which can keep acid reflux active despite treatment. Certain medications can also worsen symptoms, including common painkillers like ibuprofen, aspirin, and naproxen, as well as iron supplements and some antibiotics. When symptoms continue, people often respond by adding more reflux medicines instead of addressing what is driving the irritation in the first place. Dr Cadili said: "Pair medication use with basic trigger control. Avoid heavy late meals, leave at least a few hours between eating and lying down, and review whether painkillers or other medications could be contributing. If symptoms persist despite treatment, look at habits as well as medication." Treating trouble swallowing as ‘just reflux’ Difficulty swallowing, food feeling stuck, or needing extra water to get food down should not be treated as routine heartburn. While reflux can sometimes cause these symptoms, they can also signal inflammation, narrowing of the oesophagus, or other conditions that require medical evaluation. A common mistake is trying to manage this by increasing antacids or starting or adjusting reflux medication on your own. That may reduce burning symptoms, but does not address the underlying cause of swallowing problems, which can continue to progress unnoticed. Dr Cadili said: "Any new, worsening, or persistent difficulty swallowing should be evaluated by a healthcare professional. This is especially important if it comes with unexplained weight loss, chest pain, vomiting, or black or tar-like stools. These symptoms need prompt medical attention rather than more over-the-counter treatment."