Acid reflux · GERD

GERD care that knows how long you've been on a PPI, and when it's time to step down.

Clara's AI reads your PPI refill history, prior endoscopy if you've had one, current meds that worsen reflux, and red-flag symptoms. A physician signs off.

Get started How it works
Heartburn every night after dinner for 6 weeks. Tums helps a little. No dysphagia or weight loss.
Clara
No prior GERD workup or red-flag symptoms on file. An 8-week trial of omeprazole 20 mg before breakfast is ACG-recommended first-line. Your as-needed ibuprofen worsens reflux; I'll flag that alongside the omeprazole plan for our physician.
Any alarm symptoms I should watch for?
How it works

A reflux plan that reads your chart and reacts to alarm features.

1

Tell Clara what you're feeling

Describe heartburn, regurgitation, timing with meals, nighttime symptoms, and any alarm features. Clara auto-pulls your PPI refill history, prior endoscopy reports, current medications, and relevant conditions from 150,000+ connected records.

2

AI screens for red flags, picks the step

Clara's AI screens for ACG alarm features — dysphagia, unintended weight loss, GI bleeding, iron-deficiency anemia, persistent vomiting, or age ≥60 with new symptoms1. Then it picks between a lifestyle trial, H2-blocker, once-daily PPI, twice-daily PPI, or direct referral for endoscopy.

3

Sign-off and 8-week follow-up

A licensed physician reviews the plan and signs prescriptions. Clara schedules an 8-week check-in to reassess symptoms and consider stepping down or tapering off the PPI, per ACG guidance. If symptoms are refractory or alarm features emerge, Clara refers you to a gastroenterologist.

See your reflux plan with an 8-week step-down date already on the calendar.

Get started Free to connect records. HSA and FSA eligible.
Treatments

From lifestyle to PPI to GI referral — with a step-down plan built in.

First-line · Lifestyle

Targeted lifestyle changes

Elevate the head of the bed, don't eat within 3 hours of lying down, lose weight if BMI > 25, stop smoking, and identify trigger foods. The ACG recommends targeted lifestyle changes as part of every GERD plan, not replaced by medication1.

First
Always layered with Rx
Rx · First-line

Omeprazole (PPI) 20 mg daily

Proton pump inhibitor taken 30 minutes before breakfast for 8 weeks. First-line for typical GERD symptoms per ACG1. Clara has a detailed omeprazole page if you want the mechanism, interactions, and long-term risks.

8 weeks
Initial trial before reassessment
Rx · Step-up

Twice-daily PPI for refractory reflux

If once-daily PPI isn't fully controlling symptoms after 8 weeks and adherence/timing are confirmed, the plan may step up to twice-daily dosing. Refractory symptoms on twice-daily PPI should prompt an endoscopy or GI referral rather than open-ended escalation.

Step 2
Refractory symptoms
OTC · Alternative

H2 blockers (famotidine)

Famotidine 20–40 mg once or twice daily for milder symptoms or as on-demand therapy. Fewer long-term safety concerns than chronic PPI. Useful for nocturnal symptoms or as a PPI step-down bridge.

OTC / Rx
For milder or intermittent reflux
OTC · Rescue

Antacids (calcium carbonate, alginates)

Tums, Rolaids, or alginate-based antacids (Gaviscon) for rapid but short-lived relief. Not a substitute for consistent therapy in confirmed GERD, but fine as a rescue adjunct.

PRN
For breakthrough symptoms
Supportive · Referral

When Clara sends you to GI

Any ACG alarm feature (dysphagia, unintended weight loss, GI bleeding, iron-deficiency anemia, persistent vomiting, new reflux symptoms at age 60+), refractory symptoms on twice-daily PPI, chronic PPI use without a clear indication, or suspected Barrett's esophagus warrant endoscopy and gastroenterology1. Clara coordinates the referral.

Refer
Endoscopy + GI
Why Clara

A reflux visit that reads your PPI refill history before deciding your next step.

Clara Teladoc CVS MinuteClinic Virtual Amwell Your doctor
AI response time✓ Instant, 24/7Scheduled videoClinic hoursScheduled videoDays–weeks
Reads your PPI refill history✓Intake onlyPortions of recordsIntake onlyIf your PCP
Step-down / deprescribing plan built in✓ 8-week reviewProvider-dependentProvider-dependentProvider-dependentProvider-dependent
Screens for ACG alarm features✓ Every visitProvider-dependentProvider-dependentProvider-dependentProvider-dependent
Cost of careFree to start; $25/mo membershipVariable, often via employer$107–$164 out of pocket~$80–$100 per visit$150+ copay
Prescription may be covered by your insurance✓ Sent to your pharmacy✓✓✓✓
Coordinates GI referral when warranted✓LimitedLimitedLimited✓

A reflux visit that reads your 18 months of PPI refills before it prescribes.

Get started $25/mo, HSA and FSA eligible. Unlimited AI chat, one membership.
The AI difference

The PPI decision isn't "prescribe or not." It's "which dose, for how long, and when to step down."

Long-term PPI use without a clear indication is one of the most common deprescribing targets in primary care. The reason it persists is simple — nobody's rereading the chart at every refill. Clara does, every time.

Knows your PPI timeline

Clara sees the 18 months of omeprazole refills in your chart and asks whether the initial 8-week trial has been followed up on. Your old doctor probably does too — but only if they open the refill list.

Screens alarm features in 5 seconds

Dysphagia? Weight loss? Iron-deficiency anemia in the last labs? Clara checks every visit. A per-visit telehealth provider has to remember to ask.

Coordinates meds that make reflux worse

NSAIDs, calcium channel blockers, bisphosphonates — all on the list of meds that worsen reflux or injure the esophagus. Clara cross-references the whole chart, not just your reflux visit.

An AI that screens every ACG alarm feature on every visit.

Get started Dysphagia, weight loss, anemia, and GI bleed screen in seconds.
Common questions

GERD questions patients ask.

What does Clara cost?
It's free to connect your medical records and start chatting with Clara. If you want Clara to provide medical advice, prescribe medications, or order labs, plans start at $25/month. All plans are HSA/FSA eligible. The cost of medications and lab work is separate and may be covered by your insurance.
How is Clara different from Teladoc, CVS MinuteClinic, or my regular doctor?
Teladoc and CVS MinuteClinic both offer acid-reflux visits, but each visit is a standalone encounter with whatever provider is online — no longitudinal chart. Your regular doctor knows your chart but probably isn't checking your PPI refill timeline every refill. Clara is the AI that reads your entire chart every message, flags ACG alarm features, and builds in an 8-week step-down check. Can your old doctor read your entire chart every time? Clara can.
Should I just take an over-the-counter PPI forever?
Not without a plan. The ACG recommends an initial 8-week PPI trial for typical GERD symptoms, reassessment at the end of that trial, and step-down or deprescribing whenever possible1. Long-term PPI use has been associated with modestly increased risks of bone fracture, community-acquired pneumonia, Clostridioides difficile infection, and chronic kidney disease, though many of these associations are small in absolute terms2. Clara tracks the timeline and revisits it with you.
What counts as an alarm symptom?
ACG alarm features include difficulty swallowing (dysphagia), painful swallowing, unintended weight loss, evidence of GI bleeding (black stools, blood in vomit, iron-deficiency anemia), persistent vomiting, a family history of upper GI cancer, and new-onset reflux symptoms after age 601. Any of these should trigger an endoscopy rather than empiric PPI. Clara screens for them every visit.
Is my PPI causing side effects?
PPIs are generally well-tolerated. The long-term associations above exist but most absolute risk increases are small; the bigger question is usually whether you still need the PPI at all. Clara will walk you through your current indication, length of use, and step-down options. Abrupt PPI discontinuation can cause rebound acid hypersecretion, which is why tapering or stepping down to an H2 blocker is often used.
Do I need an endoscopy?
Most patients with typical GERD symptoms and no alarm features do not need an initial endoscopy — empiric PPI is the recommended starting point1. Endoscopy is appropriate when alarm features are present, when symptoms are refractory to adequate PPI therapy, when chronic PPI use without a clear indication needs re-evaluation, or for Barrett's esophagus screening in high-risk patients. Clara helps route you to GI when the criteria are met.
Can Clara help me get off my PPI?
Yes. If you've been on a PPI for more than 8 weeks without a chronic indication (like erosive esophagitis, Barrett's, or a long-term NSAID need), Clara will draft a structured taper — often stepping down to H2 blockers or alternate-day dosing, with targeted lifestyle changes and on-demand antacids for breakthrough symptoms. This is a classic deprescribing opportunity.
Is Clara a real medical practice?
Yes. Clara is licensed in all 50 states. Every prescription, lab order, and diagnosis is reviewed and signed off by a licensed physician. Clara's AI handles intake, clinical reasoning, triage, and follow-up; medical oversight is provided as required by state law.
Can I use Clara for other health issues too?
Yes. Clara is full-service AI-first primary care. One membership covers acid reflux alongside omeprazole refills, asthma, allergies, chronic conditions, labs, preventive care, and everything else.

A reflux plan that includes your step-down date.

Connect your records for free. See what GERD care looks like when the AI already knows your PPI history, your alarm-feature screen, and the other meds making it worse.

Get started