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doi: 10.1530/JOE-13-0525

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Contact your healthcare provider if you experience: Heartburn occurring more than twice weekly despite self-care measures Persistent symptoms despite an adequate trial of proton pump inhibitors Difficulty swallowing (dysphagia) or pain with swallowing (odynophagia) Persistent nausea or vomiting, particularly if you cannot keep down food or fluids Unintended weight loss beyond expected therapeutic effects Symptoms of gastrointestinal bleeding, including black, tarry stools or vomiting blood or material resembling coffee grounds Severe or persistent abdominal pain, especially if radiating to the back (which may indicate pancreatitis) Right upper quadrant pain, fever, or yellowing of the skin/eyes (possible gallbladder disease) Signs of dehydration (extreme thirst, dry mouth, decreased urination) with protracted vomiting Chest pain, especially if accompanied by shortness of breath, sweating, or radiation to the arm or jaw These warning signs may indicate complications such as esophagitis, gastric ulceration, or other serious conditions requiring investigation