I have to take my acid reflux meds a half-hour before I eat. I only eat two meals a day so I take one before breakfast, and the second one before supper. I also have a hiatal hernia, which thankfully hasn't been bothering me. I don't drink citrus juices, and try to chew my food well so that I'm not swallowing large pieces of food. Getting old sucks.
A friend of mine was on those anti-acid meds and developed a bad tremor. He thought he had Parkinsons but it was the PPI drugs. He stopped those drugs and began to take vinegar (I think) and the tremor gradually went away. It took a while.