Acid Reflux & GERD Surgeon | Houston Heartburn and Reflux Center
15+ years in practice
Published: August 26, 2015 | Last Reviewed: September 20, 2026
When a headache starts, most people reach for a pain reliever and expect quick relief. It’s natural to assume heartburn medications like Nexium or Prilosec work the same way. They don’t.
What the Research Found
A study published in the American Journal of Gastroenterology in June 2014 looked at how people actually take proton pump inhibitors, or PPIs, and whether they were taking them correctly.¹ The study examined when patients took the medication, whether it was over-the-counter or prescribed, and which type of heartburn drug was used.
It found that only about a third of people buying PPIs over the counter were using them correctly. Patients using a prescribed PPI were more likely to take it the right way. Incorrect use meant symptoms persisted and money was wasted on medication that never had the chance to work.
Why Timing Changes How PPIs Work
PPIs don’t relieve heartburn the way antacids do. Antacids neutralize acid on contact. PPIs work differently. They block acid production at its source, but only once they build up in your system.
Food helps activate PPIs. That is why the ideal time to take them is before breakfast, not after symptoms start. PPIs do not provide immediate relief. It can take up to seven days of consistent daily use before you feel the full benefit.
To help the medication work as intended, take it before a meal that includes acid-stimulating foods or drinks. Eggs, cheese, yogurt, milk and coffee are common examples.
Why This Matters for Long-Term Relief
Even when taken correctly, PPIs treat symptoms. They do not fix the underlying cause of reflux. I see many patients who have followed dosing instructions carefully and still have breakthrough symptoms, because a PPI cannot repair a weak or herniated antireflux barrier. That requires an anatomic solution.
Key Clinical Points
- Most PPI users take the medication incorrectly, which blunts its effectiveness and wastes money.
- PPIs must be taken consistently, once daily, ideally before a meal that includes acid-stimulating foods.
- PPIs can take up to seven days of regular use to reach full effect. They are not a rescue medication like antacids.
- PPIs are not a long-term solution. They manage symptoms without correcting the underlying reflux barrier.
If you are taking heartburn or acid reflux medication correctly and still have severe symptoms, it’s time for an evaluation. I encourage you to call Houston Heartburn and Reflux Center at 832-945-8717.
Elias Darido, MD, FACS
Houston Heartburn and Reflux Center
Originally published: August 26, 2015 | Last reviewed: September 20, 2026
Reference
¹ Sheikh I, Waghray A, Waghray N, Dong C, Wolfe MM. Consumer use of over-the-counter proton pump inhibitors in patients with gastroesophageal reflux disease. Am J Gastroenterol. 2014;109(6):789–794. doi:10.1038/ajg.2013.421