British doctors are right to issue a warning about plans to make an acid reflux drug freely available to buy over the counter as it could potentially put people at risk.

Drugs giant Pfizer has applied to switch its Nexium medicine, which contains the proton pump inhibitor (PPI) esomeprazole, from a pharmacy-only drug to general sale.

BMA representative Dr Andrew Green told the publication: “The provision of PPIs as pharmacy only drugs allows patients to have good access to these medications while maintaining the overview of a pharmacist, who can direct the patient to their GP if indicated.”The British Medical Association (BMA) is concerned by the application, according to Pulse magazine, because patients could get medication over the counter without getting their symptoms properly investigated.

Pfizer argues that switching Nexium to general sale guarantees people have wider access and more choice to effectively treat their symptoms but we agree that it is far more important for people to get an accurate diagnosis before undertaking any treatment.

People should only really be taking PPIs if they have a confirmed acid reflux diagnosis, not just because reflux is suspected.

Yes, PPIs can be effective at stopping symptoms but they don’t actually stop the reflux, instead they alter the acidity of the stomach contents by blocking the site of acid production in the stomach cells – the proton pump.

It can then be very difficult for someone who uses PPIs for more than a month to come off the medicine. Because the inhibitors prevent acid production, they can sometimes cause acid rebound so someone who didn’t actually have reflux to start with develops it because they now have an excess of acid.

There are also concerns that PPIs can mask underlying causes of symptoms which could include serious illnesses such as ulcers, cancers, or gastric abnormalities.

Peptest is a non-invasive diagnostic test for all types of reflux disease. It measures the presence of pepsin in a clinical sample, which is a reliable marker for the reflux of gastric juice.

A positive Peptest can help a patient and their GP decide on the best way to manage their reflux to help with their specific symptoms. Equally, a negative result demonstrates that other factors could be involved in causing the symptoms and further advice is just as important.

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