Is it okay to use proton-pump inhibitors on demand?

When doctors say that it’s okay to take proton-pump inhibitors (PPIs) “on demand” for chronic heartburn, the advice doesn’t apply to everyone. PPIs inhibit the production of stomach acid, which can back up into the esophagus and can cause pain (heartburn) and damage the lining of the esophagus. People with damage to the esophagus often stay on PPIs long-term to prevent further problems. People without damage to the esophagus can take a short course of PPIs as needed.