Conditions
Acid reflux treatment (heartburn) by telehealth in Puerto Rico
Acid reflux treatment starts with habit changes, such as eating at least 3 hours before lying down and raising the head of your bed, and can include medicines that lower stomach acid. By video, the doctor evaluates you, recommends a plan and, if appropriate, sends your prescription to your pharmacy. Chest pain that could be your heart is an emergency: call 911.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Severe or squeezing chest pain that spreads to the arm, jaw or back, or comes with shortness of breath, a cold sweat or dizziness
- Vomit with blood or that looks like coffee grounds
- Black, tarry or bloody stools
- Trouble swallowing or food getting stuck
- Unexplained weight loss
Help lines
At a glance
Gastroesophageal reflux disease
Common symptoms
- Heartburn: a painful, burning feeling in the middle of the chest
- Regurgitation
- Nausea
- Trouble swallowing
- A chronic cough or hoarseness
- Other names
- Acid reflux · Heartburn · GERD
- Treatment
- Habit changes; antacids, H2 blockers or proton pump inhibitors as the medical evaluation indicates
- Possible complication
- Inflammation of the esophagus; warning signs may need an endoscopy
On this page(11)
What is acid reflux?
Reflux happens when stomach contents come back up into the esophagus, the tube that carries food from your mouth to your stomach. Occasional reflux, for example after a big meal, is common. If what you feel is mostly an urge to throw up, see nausea.
When the muscle at the bottom of the esophagus becomes weak or relaxes when it should not, reflux becomes frequent or long-lasting, and it is called gastroesophageal reflux disease (GERD). Not everyone with GERD has heartburn; some mainly have a cough or hoarseness.
Acid reflux treatment by telehealth
You see Dr. Diana Nieves Castro, MD, a general practice physician licensed in Puerto Rico (verify her license) with several years of emergency-department experience. She sees you in English or Spanish, and we care for adults and children of all ages. We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
If reflux has been with you for a while, we follow it with you as part of our chronic care. In the visit, the doctor:
- Reviews your symptoms, when they happen and what makes them worse.
- Helps you build a habits and weight plan that works for you.
- Recommends the right medicine. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
- Refills a reflux medicine you already take and checks that it is still the right one.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
How to book your visit in 3 steps
It works the same from anywhere in Puerto Rico:
Request your visit.
Request a visit online 24/7 — we confirm your time by email or text. Choose Doctor visit, or Follow-up visit if you only need a refill of a medicine you already take, and pay by card at secure checkout. Book your visit.
Get your link.
We send you a secure video link. It works on your phone, tablet or computer. You need to be in Puerto Rico during the visit (visitors are welcome). Patients under 21 need a parent or legal guardian on camera with photo ID.
See the doctor.
The doctor evaluates, diagnoses and treats you. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If you need a test, we give you a lab order for a lab near you.
Price: a US$79 doctor visit, no membership
A doctor visit costs US$79, the same price for every age, with no membership and no insurance needed. You are charged when you request the visit, and you get a full refund if the visit can't happen. A doctor's note after your visit is included at no extra charge. See all prices.
If you already take a reflux medicine and only need a refill, choose a follow-up visit: it costs US$49 and anyone can book it. A review of lab results is also US$49 for existing patients. If a US$49 visit turns out to need a full visit, the doctor explains why and, with your consent, you pay the difference.
Video visit
Doctor visit
US$79
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
Acid reflux symptoms
The most common symptoms are:
- Heartburn: a painful, burning feeling in the middle of the chest
- Regurgitation: stomach contents coming back up into the throat or mouth
- Nausea
- Trouble swallowing
- A chronic cough or hoarseness
Reflux medicines, and when more tests are ordered
There are three main groups. Antacids relieve mild symptoms but should not be used every day without medical advice. H2 blockers reduce how much acid the stomach makes. Proton pump inhibitors are the most effective at lowering acid and healing the esophagus; like any medicine, they can have side effects. The doctor decides with you which one is appropriate.
If your symptoms do not improve with habit changes and medicine, or you have trouble or pain swallowing, unexplained weight loss, loss of appetite or vomiting that will not stop, the doctor refers you to a gastroenterologist, who may do an endoscopy to look inside your esophagus.
Habits that help
These changes, recommended by the NIDDK, help many people and are the first step of treatment:
- Eat at least 3 hours before you lie down or go to bed.
- If reflux bothers you at night, raise the head of your bed 6 to 8 inches with a foam wedge or pillows under your head and upper back.
- Lose weight if you are overweight.
- Quit smoking.
- Notice which foods bother you. Common ones are acidic foods (citrus, tomatoes), alcohol, chocolate, coffee and other caffeine, high-fat foods, mint and spicy foods.
Reflux, weight and Puerto Rico
Losing weight is one of the steps that helps reflux most. In Puerto Rico, adult obesity rose from 26.3% in 2011 to 36.2% in 2024, according to BRFSS surveillance data published by the Puerto Rico Institute of Statistics. If you want a plan for your weight and your reflux, the doctor works through it with you during the visit.
Reflux in children and teens
We see children of all ages, with a parent or legal guardian on camera. Spitting up is very common in babies, and the doctor helps you tell it apart from reflux that needs treatment. For their safety, if a child vomits forcefully, vomits green or blood, or is very drowsy or limp, take them to the emergency room.
When to go to the ER
Heartburn feels like burning in the middle of the chest, and a heart attack can also be felt in the chest. For your safety, call 911 if the pain is severe or squeezing, spreads to your arm, jaw or back, or comes with shortness of breath, a cold sweat, nausea or dizziness. This matters even more if you have high blood pressure, diabetes or high cholesterol, or if you smoke.
Also go to the ER if you have any of these signs. See when to go to the ER.
- Vomit with blood or that looks like coffee grounds
- Black, tarry or bloody stools
- Food getting stuck so you cannot swallow
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
How can I tell heartburn from a heart problem?
Which foods make reflux worse?
Can acid reflux be treated by telehealth?
When does reflux need an endoscopy?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (4)
- NIDDK (NIH): Symptoms and causes of GER and GERD in adults (opens in a new tab) (accessed 2026-09-30)
- NIDDK (NIH): Treatment for GER and GERD in adults (opens in a new tab) (accessed 2026-09-30)
- NIDDK (NIH): Eating, diet and nutrition for GER and GERD in adults (opens in a new tab) (accessed 2026-09-30)
- Puerto Rico Institute of Statistics: World Obesity Day (BRFSS data, Spanish) (opens in a new tab) (accessed 2026-09-30)