• Under 2 years old.
• Heartburn that continues during or after an over the counter treatment (OTC treatments are not working).
• Very severe, agonizing pain.
• Heartburn during sleep, or heartburn that is disrupting sleep.
• Heartburn more than two days per week for three months or more.
• Vomiting.
• Black tarry stools.
• Choking, coughing, wheezing, or hoarseness.
• Persistent nausea or diarrhea with onset of heartburn.
• Chest pain, jaw pain, or left arm or shoulder pain accompanied by sweating.
• Pregnancy or nursing.
• Pain when swallowing.
• Low magnesium levels.
• Have allergies to OTC medications used to treat heartburn.
• Taking prescription medications including warfarin, methotrexate, digoxin, clopidogrel, cilostazol, anti fungal medications, tacrolimus, mycophenolate mofetil, HIV medications, thyroid medications.
• Indigestion suddenly occurring to someone who is over 45 years old.
• Recent weight loss with no known cause.