Heartburn & Reflux

Heartburn is a burning sensation behind the breastbone caused by stomach acid flowing back into the oesophagus. If it occurs regularly, this is referred to as gastro-oesophageal reflux disease (GERD). In the video consultation, a structured history-based assessment is carried out; following the doctor's evaluation, a private prescription, for example for proton pump inhibitors, may be issued.

Medically reviewed by Adi Zoabi, Approbation als Arzt.
Last reviewed on August 31, 2026. Updated as clinical guidelines change.

Overview

Heartburn is one of the most common digestive complaints: a substantial proportion of adults in Germany are affected at least occasionally. It is caused by acidic stomach contents flowing back into the oesophagus, producing a burning sensation behind the breastbone, sour belching or an unpleasant taste in the mouth. If symptoms occur regularly or impair quality of life, this is referred to as gastro-oesophageal reflux disease (GERD). Many cases can be assessed well on the basis of a careful medical history, without an immediate in-person examination. In the OpenClinic24 video consultation, experienced doctors record your symptoms in a structured way, check for possible warning signs and discuss the next steps with you. Following the doctor's evaluation, a private prescription can be issued, for example for proton pump inhibitors, complemented by individual advice on diet and lifestyle. Billing is provided as a private service according to the German GOÄ fee schedule for privately insured patients and self-payers.

Common causes

In heartburn, the lower oesophageal sphincter does not close sufficiently, allowing stomach acid to flow back. This is promoted by large, fatty or heavily spiced meals, eating late before bedtime, and by coffee, alcohol, nicotine and carbonated or very acidic drinks. Excess weight increases pressure in the abdomen and is one of the most important risk factors; reflux is also common during pregnancy. A hiatal hernia can additionally weaken the valve function at the entrance to the stomach. Some medicines can relax the sphincter or irritate the mucous membrane, which is why reviewing your current medication is part of the medical assessment. Stress and irregular eating habits can also aggravate symptoms. Several factors often act together; the medical history helps to identify the triggers that are relevant in your case.

When to see a doctor

Occasional heartburn after a large meal is usually harmless. You should have your symptoms medically assessed if they occur several times a week, persist for more than a few weeks, disturb your sleep or do not improve despite self-treatment. Certain warning signs require a prompt in-person examination, usually including a gastroscopy: difficulty or pain when swallowing, unintended weight loss, repeated vomiting, blood in vomit, black stools or newly diagnosed anaemia. New symptoms at an older age should also be thoroughly investigated. Important: sudden, severe pain behind the breastbone, especially with shortness of breath, tightness, radiation into the arm, jaw or back, cold sweat or nausea, may be a heart attack. In this case, call emergency services 112 immediately and do not wait for a video consultation.

Symptoms & Indications

Burning sensation behind the breastbone (heartburn) Acid regurgitation and sour belching Backflow of stomach contents into the mouth or throat (regurgitation) Pressure or feeling of fullness in the upper abdomen Dry, irritating cough or frequent throat clearing, especially at night Hoarseness in the morning Symptoms when lying down or bending over Worsening after large, fatty or late meals

Treatment Options

Structured medical history and reflux assessment in the video consultation
Following the doctor's evaluation, a private prescription for acid-reducing medicines such as proton pump inhibitors
Advice on over-the-counter options such as antacids or alginates for short-term symptom relief
Dietary advice: smaller meals, avoiding late, fatty or heavily spiced foods
Lifestyle advice: weight reduction, avoiding nicotine and alcohol, sleeping with the upper body elevated
Review of your current medications for reflux-promoting effects
Triage: recommendation for gastroscopy in case of warning signs or persistent symptoms

Important Notes

The video consultation does not replace a gastroscopy. In case of warning signs or symptoms persisting despite treatment, an in-person gastroenterological work-up is required.
Difficulty swallowing, unintended weight loss, blood in vomit, black stools or known anaemia are warning signs that must be assessed promptly by a doctor in person.
Sudden, severe chest pain, especially with shortness of breath, radiation into the arm or jaw, cold sweat or nausea, may indicate a heart attack. In this case, call emergency services 112 immediately.

HOW IT WORKS

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STEP 03

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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

Can I get a prescription for heartburn via video consultation?

Following the doctor's evaluation, a private prescription can be issued in the video consultation, for example for proton pump inhibitors. This requires a structured medical history without any indication of warning signs. Whether and which medication is suitable is decided by the doctor together with you.

How much does heartburn treatment at OpenClinic24 cost?

Billing is provided as a private medical service according to the German medical fee schedule (GOÄ). Privately insured patients can usually submit the invoice to their private health insurer; self-payers receive a transparent GOÄ invoice. You will see the expected costs before booking. Reimbursement by statutory health insurance is not provided.

When are lifestyle changes enough, and when are medicines advisable?

For occasional heartburn, smaller meals, avoiding late and fatty foods, and weight reduction are often sufficient. If symptoms occur several times a week or affect your sleep and daily life, a time-limited course of acid-reducing medication may additionally be advisable following the doctor's evaluation. You and the doctor will decide together in the video consultation which combination suits you.

Do I need a gastroscopy?

Not every case of heartburn requires an immediate gastroscopy. However, a gastroscopy is recommended in case of warning signs such as difficulty swallowing, unintended weight loss or signs of bleeding, as well as for long-standing or treatment-resistant symptoms. This assessment is made in the video consultation, and if needed you will receive a specific recommendation for in-person evaluation.

Are proton pump inhibitors suitable for long-term use?

Proton pump inhibitors are considered well tolerated when used for a limited period. Long-term use should be medically supervised and reviewed regularly, as it is only appropriate with a corresponding diagnosis. The duration and necessity of acid-reducing treatment are discussed individually in the video consultation.