A 45-year-old woman presents with persistent heartburn and indigestion after meals, uses over-the-counter antacid tablets regularly for the last month, and reports a persistent dry cough and a sour taste in her mouth at night. What is the most appropriate action?

• A. Refer the patient to her GP for further investigations and treatment
• B. Continue using OTC antacids and monitor symptoms
• C. Recommend switching to a different brand of antacid
• D. Advise that symptoms are harmless and require no medical review

Answer: (A)

Persistent reflux symptoms with nocturnal cough in a middle-aged woman should prompt medical review to assess for gastroesophageal reflux disease and any potential complications. The combination of ongoing heartburn and indigestion for a month despite using OTC antacids, plus nighttime symptoms such as a dry cough and sour taste, are red flags that point beyond simple heartburn management. A GP can evaluate the diagnosis more thoroughly, rule out other conditions, and tailor treatment—often starting a proton pump inhibitor and advising lifestyle changes, while checking for alarm features and considering investigations if needed.

Continuing with self-treatment or switching brands doesn’t address the underlying issue and may miss the opportunity to diagnose a condition that could require prescription therapy and monitoring. Calling this harmless and foregoing medical review would risk delayed care.