Dr Punam Krishan shared advice for people who take omeprazole or lansoprazole for conditions such as heartburn, acid reflux and indigestionGeorgia Burns Trainee Trends, Showbiz and Lifestyle Writer and Charlotte Smith
11:04, 08 Feb 2026
The NHS GP warns anyone taking PPIs to get regular check-ups to avoid long-term risks and symptoms (Image: Getty)
Dr Punam Krishan, the resident doctor on BBC’s Morning Live and an NHS GP, warns people taking proton pump inhibitors (PPIs) such as omeprazole for conditions like heartburn, acid reflux and indigestion need to be careful. In the UK, around a quarter of adults experience acid reflux, with many encountering episodes throughout their lives, often after large meals.
For those with ongoing symptoms, doctors may prescribe PPIs like omeprazole to ease discomfort. However, Dr Punam emphasises the need for vigilance, especially for long-term users, highlighting the importance of regular medical check-ups while on these medications.
Speaking to BBC Morning Live hosts Gethin Jones and Helen Skelton, the medical expert opened her warning by explaining to viewers what acid reflux actually is. She explained: “Acid reflux is all about what happens in your stomach. So we all have acid in our stomach and it has a very important role.
“The role of that is to break down and digest the food. Now, at the top of the stomach, we have a little valve, a sphincter, and it acts like a trapdoor. And its job is to basically seal the contents so the acid is not essentially tracking back up the food pipe, your oesophagus.
“However, if that sphincter, that valve, becomes too loose, it can become very relaxed by things like heavy meals. If you’ve had alcohol, if you lie down straight after having a heavy meal, that can actually mean that acid from the stomach can end up creeping back up the food pipe and cause that heavy pressured burning sensation that people get.”
Dr Punam explained what can happen when PPIs are taken over an extended period(Image: BBC)
Host Gethin went on to ask about the common ways to treat these issues, to which Dr Punam explained there are various approaches available. On the episode, which aired late last year but remains relevant today, she explained: “So there are lots of different things that we can do.
“If, of course, you’re having it just every now and then, then lots of people do get antacids or basically medications like alginates. Examples of that include Gaviscon. And these basically help to just kind of neutralise the acid. They’re very effective and you can just use them as and when needed.”
For ongoing or more severe discomfort, she pointed out doctors commonly prescribe proton pump inhibitors, including medications like omeprazole and lansoprazole. “If the discomfort is persistent, we often prescribe proton pump inhibitors, PPIs for short. Examples of these are omeprazole, lansoprazole. And these are incredible and have really transformed the way that we treat acid reflux. They essentially help to treat the acid production at the source.”
The NHS GP issued a caution to PPI users, explaining: “Essentially these medications aren’t there to be used unnecessarily or for a long period of time. They do require us to review them. And that’s because if used over a long period of time, they can slightly increase your risk of things like low magnesium, low vitamin B12, but also increase the risk of gut infections, particularly Clostridioides difficile. We call that C. diff for short.”
Highlighting the need for regular check-ups for those on long-term PPI medication, Dr Punam added: “Now, we have this bacteria in our bowel, you and I, we all have it, and it lives in balance. However, medications like PPIs can tip that balance. And if you get overgrowth of this bacterium, it can cause persistent diarrhoea. That is a red flag.
“So you do need to speak to your doctor if that is an issue and you suddenly start developing diarrhoea. Or if you’ve got a change in bowel habit, we always say check in with your doctor. Just make sure that you are getting those reviews with your GP.”
Helen questioned: “I guess the trouble is if it works, you stick with it, don’t you?” Dr Punam agreed: “Yeah, it is.”
Gethin then added: “But you don’t even know how long you’re taking it for in the end, are you?” Dr Punam said: “Well, that’s just it. Sometimes you can just be taking it, and the problem is resolved, but you’re just taking the medication. So do go in for your regular reviews.”
How often should PPI users visit their GP?
Omeprazole can be prescribed or sometimes purchased without a prescription(Image: Getty Images)
If you’re taking over the counter omeprazole, it should not be used for longer than two weeks and you may need to see a doctor in certain situations.
For those prescribed omeprazole for long term use, regular monitoring by a doctor is important. Your GP will set up a follow-up consultation based on your individual health needs and risk factors, usually every six to 12 months.
If your GP recommends using omeprazole for more than a year, ongoing reviews are essentiall to help minimise the risk of long-term side effects.
Which symptoms require attention?
Low magnesium symptoms may include muscle cramps, fatigue and irregular heartbeat, along with less obvious signs such as loss of appetite, nausea and general weakness. Severe deficiencies can cause numbness, tingling, personality changes, seizures and abnormal heart rhythms.
Indicators of vitamin B12 deficiency can include tiredness, weakness, paleness and a sore or inflamed red tongue. Other possible effects include neurological issues such as tingling, balance problems, cognitive difficulties, as well as shortness of breath, palpitations and digestive problems.
Signs of a C. diff intestinal infection involve loose or watery bowel movements, abdominal cramping and discomfort, elevated temperature (fever), feeling sick, reduced appetite and fluid loss.
Omeprazole is taken by many patients in the UK(Image: GettyImages)
In serious cases, complications can arise, including potentially life-threatening inflammation of the bowel.
What tests are available for confirmation?
Helen asked: “What if you want to do something without medication? Can you ease the symptoms without taking any meds?”
To which Dr Punam replied: “So if you have got symptoms that have not settled despite you trying to manage them, then it is important to check in with your GP because we would want to investigate that further.
“Ultimately, you want to find out what is the root cause of this and is it something more serious. We would do tests like checking for a bacterium called Helicobacter pylori, which increases the production of acid. We may refer you for a gastroscopy. This is a camera test that goes into the stomach to see is there any inflammation, any ulcers, anything more serious.”
What alternative treatments exist beyond medication?
Heartburn, acid reflux and indigestion is often triggered by substantial meals(Image: GettyImages)
Dr Punam explained: “At the end of the day, medications are great, but there’s lots of things that we can do every day in our lifestyles that make a massive, massive difference. The first thing is if you are struggling with heartburn, indigestion, acid reflux, then eat smaller portions.
“If you eat big, heavy meals, you can actually put a lot of pressure on your stomach. Again, we’re going back to that valve, which can become a bit lax and cause acid to track up.
“Avoid lying down after a meal for at least three to four hours. When we lie flat, the sphincter relaxes, and acid can return to the oesophagus.
“If you have symptoms, prop up your pillows so your chest is slightly higher than your waist, so you’re just slouched up a little bit. Again, avoid lying flat. It really, really works a treat.
“Don’t wear tight clothes. We all want to loosen that button on your jeans after a meal, but actually just get into looser clothing because tight clothes can actually put a lot of pressure on your stomach as well.
“Gentle teas like chamomile work really well. Ginger tea is fantastic. Chamomile works really well, ginger tea is fantastic. A lot of people turn to mint. Now mint is great if you’ve got IBS or tummy cramps, but actually for reflux it can make the problem worse. So stick to ginger tea or chamomile tea.
“Avoid certain foods as well. Knowing your triggers. So keep a diary. I’m a big one for diaries. Look at when you get your symptoms, what have you had or done that day that could have exacerbated them. Taking them into your doctor is a real help to us. And that and also managing your weight. I think that goes without saying can make a big difference.”