Why won’t my heartburn go away, even on medicine?

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Why medicine may not be enough

Proton pump inhibitors (PPIs) such as omeprazole and pantoprazole lower the acid in your stomach. They do not stop stomach contents from flowing back up. If the valve between the esophagus and stomach is weak, or part of the stomach has slipped up through the diaphragm (a hiatal hernia), you can keep having regurgitation, a sour taste, cough or hoarseness even while taking medicine.

Sometimes the symptoms are not reflux at all, which is another reason testing matters before any treatment decision.

How it is evaluated

• An upper endoscopy (EGD) to look at the esophagus and stomach, sometimes with MiVu™ mucosal integrity testing
• Esophageal manometry to check how the esophagus squeezes
• Imaging such as a barium swallow or CT scan, and acid (pH) monitoring in some patients

What can help

Lifestyle steps such as smaller meals, not eating late, raising the head of the bed and reaching a healthier weight help many people. When reflux continues despite these steps and medicine, or you would rather not take medicine long term, anti-reflux surgery with hiatal hernia repair may be an option. Dr. Tufts performs these operations with minimally invasive surgery, either laparoscopically or with the Da Vinci robotic system.

If an EGD shows Barrett’s esophagus, regular surveillance endoscopy becomes part of your long-term care.

When to see a surgeon

• Heartburn or regurgitation most days despite medicine
• Trouble swallowing, food sticking, or weight loss you cannot explain
• Chronic cough, hoarseness or a sour taste in the morning
• A hiatal hernia found on a scan or endoscopy

Get urgent care: Chest pain can come from the heart. Call 911 for chest pain with shortness of breath, sweating or pain spreading to the arm or jaw.

Learn more: Hiatal hernia & anti-reflux surgery guide · Reflux & hiatal hernia overview

Talk with Dr. Tufts

Dr. Tufts is a minimally invasive and endoscopic general surgeon. To have your symptoms evaluated or talk through your options, call (941) 391-5102 to schedule a visit at Charlotte Harbor Surgical, 4245 Kings Hwy, Unit A, Port Charlotte, FL 33980. We see patients from Port Charlotte, Punta Gorda, North Port, Englewood, Cape Coral and North Fort Myers and across Southwest Florida.

Written and medically reviewed by Dr. Matthew Tufts, MD, FACS, a board-certified minimally invasive and endoscopic general surgeon in Port Charlotte, FL. Last reviewed 2026-11-11.

This page is general information, not medical advice. Every patient is different. Dr. Tufts will review your history, exam and test results with you and explain the options, benefits and risks that apply to you.