Personally I think PPIs like Omeprazole can actually make things worse - particular if used long term. They are meant to be used for only an few weeks at a time as they effect absorption of food so can result in osteoporosis and other problems. Weaning yourself of them can also be difficult as they suppress the stomach acid and when you stop PPIs this results in a rebound action of extra acid fro a time till the body adjusts!
Acid reflux and heartburn are tricky - I have simply changed what I eat and how I eat to prevent indigestion and heartburn - SO. - I eat small meals (half portions) more often through the day, with less fat and indigestible foods e.g. onion and milk and I try to eat slowly.
HRT can ‘sometimes' cause gall stones when first started HRT - look this up and discuss with your GP - and this could be the pain you are experiencing (is the pain up towards your right shoulder?) - you need to cut down on fatty foods - the PPIs may be effecting your body's ability to break down fatty foods???
Foods to avoid: Foods that are fried, like french fries and potato chips.
High-fat meats, such as bacon, bologna, sausage, ground beef, and ribs.
High-fat dairy products, such as cheese, ice cream, cream, whole milk, and sour cream.
Pizza.
Foods made with lard or butter.
Creamy soups or sauces.
Meat gravies.
Chocolate.I also take digestive enzymes that aid digestion and have Gaviscon tablets after my evening meal.
If you take HRT on an empty stomach then I would expect some heartburn but, if taken with food, HRT could actually help the digestive system - however we are all different so HRT will effect us differently. Your symptoms may subside but I really wouldn't increase your PPIs - just change you diet.
DG x