Millions of people in the US suffer from acid reflux, either on an occasional or frequent basis, and as of this year over 15 million Americans are using either over-the-counter or prescription medication to help them deal with their symptoms.

Reflux medications can bring some pretty significant relief to patients struggling with reflux and heartburn, especially if their reflux isn’t chronic. That being said, they don’t always work like they’re supposed to. Every patient is different, and there are many cases where medication isn’t an appropriate treatment for your symptoms. Here are 6 tell-tale signs that your acid reflux medication isn’t working: