Education only. Not medical advice.
Personalize with your clinician.

TL;DR

Smaller, lower-fat meals help most. Stop eating 2–3 hours before bed and elevate the head of the bed at night. If symptoms show up ≥2 days/week, many clinicians try a once-daily PPI taken 30–60 minutes before breakfast. Alginates after meals can calm post-meal burn. Hold GLP-1 dose increases on bad weeks. Escalate care if red flags appear.

Why heartburn can flare on GLP-1s

GLP-1s slow stomach emptying and lower appetite. In early weeks, bigger or high-fat meals can sit longer and trigger reflux. The goal is comfort while you ramp: adjust meal size and timing, sleep with gravity on your side, and use meds correctly.

First moves that actually help

• Meal size + fat: Smaller portions and lower-fat cooking, especially during titration.

• Timing: Finish dinner 2–3 hours before lying down; avoid late snacks.

• Sleep setup: Raise the head of the bed or use a wedge; left-side sleeping helps night symptoms.

• Daily movement + steady loss: Gentle walks after meals and steady—not crash—weight loss support reflux control.

Meds that make sense (how to take them)

• PPI (omeprazole-class): Take 30–60 minutes before breakfast for best effect. For persistent nights, your clinician may adjust timing or dose.

• H2 blocker (famotidine-class): Good for milder or breakthrough evening symptoms.

• Alginate “raft” after meals/bedtime: Sits on top of stomach contents and reduces post-meal episodes; useful add-on.

• Antacids: Quick relief for occasional flares; not a long-term fix.

Escalate or hold: simple rules

• Hold GLP-1 dose increases during weeks with frequent heartburn or nighttime symptoms; resume when comfortable.

• Escalate meds if symptoms persist ≥2 days/week despite basics; many try a daily PPI trial and reassess at 2–4 weeks.

• If a PPI “doesn’t work,” fix timing first. Most misses are timing or skipped doses.

Night playbook

Eat dinner earlier. Elevate the bed 6–8 inches or use a wedge. Sleep on your left side when symptoms flare. Keep water at the bedside; skip alcohol and fizzy drinks at night.

Meds to review with your prescriber

Some drugs relax the valve or irritate the lining. Ask about timing or alternatives if you use calcium-channel blockers, nitrates, anticholinergics, benzodiazepines, NSAIDs, or certain osteoporosis meds.

When to scope or test

• Trouble swallowing, bleeding, persistent vomiting, unplanned weight loss, anemia, or chest pain

• No improvement after an optimized 8-week PPI trial

GLP-1 specifics to remember

• Titration weeks are the high-risk window for nausea/fullness. Put your larger meal at the time of day you feel best.

• GLP-1s delay gastric emptying; mention them before anesthesia or deep sedation so you get proper hold or diet instructions.

ScriptScores™: What actually helps (0–10)

Higher = better for most women 50–64 on GLP-1s.

One-week reset that usually helps

Days 1–2: Shrink portions, lower fat, move dinner earlier, add a bed wedge, and try left-side sleeping.
Days 3–7: If symptoms still hit ≥2 days/week, start a daily PPI before breakfast; add alginate after meals as needed. Re-evaluate in 2–4 weeks or after any dose change.

Disclaimers

• Not medical advice. Education only.

• Safety first. Choose, pace, and adjust with a licensed clinician.

• ScriptScores™. Comparison tool for day-to-day decisions, not treatment directives.