Heartburn / acid reflux

Frequent heartburn — burning behind the breastbone after meals or at night, regurgitation, sour taste — points to GERD. Clindle treats with lifestyle changes (weight, alcohol, late meals, head-of-bed elevation), H2 blockers like famotidine, and proton-pump inhibitors like omeprazole or pantoprazole, stepped down to the lowest effective dose. Alarm features (trouble swallowing, weight loss, vomiting blood, age >60 with new symptoms, anemia) trigger a GI referral for endoscopy. Heartburn-like chest pain with sweating or radiation to the arm should be evaluated as a possible cardiac event.