6.2. Heartburn Extrapolation from adult data suggests that in older children and adolescents, on-demand therapy with buffering agents, sodium alginate, or H2RA may be used for occasional symptoms. Adolescents with typical symptoms of chronic heartburn should be treated with lifestyle changes if applicable (diet changes, weight loss, smoking avoidance, sleeping position, no late-night eating) and a 2- to 4-week trial of PPI. If symptoms resolve, PPIs may be continued for up to 3 months. Heartburn that persists on PPI therapy or recurs after this therapy is stopped should be investigated further by a pediatric gastroenterologist.