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Get Rid of Heartburn and GERD Forever in Three Simple Steps

Note: this is the sixth and final article in a series about heartburn and GERD. If you haven’t done so already, you’ll want to read Part I, Part II, Part III, and Part IVa, and Part IVb before reading this article.

In this final article of the series, we’re going to discuss three steps to treating heartburn and GERD without drugs. These same three steps will also prevent these conditions from developing in the first place, and keep them from returning once they’re gone.

To review, heartburn and GERD are not caused by too much stomach acid. They are caused by too little stomach acid and bacterial overgrowth in the stomach and intestines. Therefore successful treatment is based on restoring adequate stomach acid production and eliminating bacterial overgrowth.

This can be accomplished by following the “three Rs” of treating heartburn and GERD naturally:

  1. Reduce factors that promote bacterial overgrowth and low stomach acid.
  2. Replace stomach acid, enzymes and nutrients that aid digestion and are necessary for health.
  3. Restore beneficial bacteria and a healthy mucosal lining in the gut.
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Reduce Factors That Promote Bacterial Overgrowth and Low Stomach Acid

Carbohydrates

As we saw in Part II and Part III, a high-carbohydrate diet promotes bacterial overgrowth. Bacterial overgrowth—in particular H. pylori—can suppress stomach acid. This creates a vicious cycle where bacterial overgrowth and low stomach acid reinforce each other in a continuous decline of digestive function.

It follows, then, that a low-carb diet would reduce bacterial overgrowth. In studies done to test this hypothesis, the results have been overwhelmingly positive. Carbohydrate intake (especially simple sugars) is correlated with GERD symptoms, and reducing that intake can lead to a reduction in those symptoms. (1)

In a study performed by Professor Yancy and colleagues at Duke University, researchers worked with five patients with severe GERD that also had a variety of other medical problems, such as diabetes. (2) Each of these patients had failed several conventional GERD treatments before being enrolled in the study. In spite of the fact that some of these patients continued to drink, smoke and engage in other GERD-unfriendly habits, in every case the symptoms of GERD were completely eliminated within one week of adopting a very-low-carbohydrate diet.

Another study was performed by Yancy and colleagues a few years later. (3) This time they examined the effects of a very-low-carb diet on eight obese subjects with severe GERD. They measured the esophageal pH of the subjects at baseline before the study began using something called the Johnson-DeMeester score. This is a measurement of how much acid is getting back up into the esophagus, and thus an objective marker of how much reflux is occurring. They also used a self-administered questionnaire called the GSAS-ds to evaluate the frequency and severity of 15 GERD-related symptoms within the previous week.

At the beginning of the diet, five of eight subjects had abnormal Johnson-DeMeester scores. All five of these patients showed a substantial decrease in their Johnson-DeMeester score (meaning less acid in the esophagus). Most remarkably, the magnitude of the decrease in Johnson-DeMeester scores is similar to what is reported with PPI treatment. In other words, in these five subjects a very-low-carbohydrate diet was just as effective as powerful acid suppressing drugs in keeping acid out of the esophagus.

All eight individuals had evident improvement in their GSAS-ds scores. The GSAS-ds scores decreased from 1.28 prior to the diet to 0.72 after initiation of the diet. What these numbers mean is that the patients all reported significant improvement in their GERD related symptoms. Therefore, there was both objective (Johnson-DeMeester) and subjective (GSAS-ds) improvement in this study.

It’s important to note that obesity is an independent risk factor for GERD, because it increases intra-abdominal pressure and causes dysfunction of the lower esophageal sphincter (LES). The advantage to a low-carb diet as a treatment for GERD for those who are overweight is that low-carb diets are also very effective for promoting weight loss.

I don’t recommend very-low-carb diets for extended periods of time, as they are unnecessary for most people. Once you have recovered your digestive function, a diet low to moderate in carbohydrates should be adequate to prevent a recurrence of symptoms.

An alternative to a very-low-carb is something called a “specific carbohydrate diet” (SCD), or the GAPS diet. In these two approaches it is not the amount of carbohydrates that is important, but the type of carbohydrates. The theory is that the longer chain carbohydrates (disaccharides and polysacharides) are the ones that feed bad bacteria in our guts, while short chain carbohydrates (monosacharides) don’t pose a problem. In practice what this means is that all grains, legumes and starchy vegetables should be eliminated, but fruits and certain non-starchy root vegetables (winter squash, rutabaga, turnips, celery root) can be eaten. These are not “low-carb” diets, per se, but there is reason to believe that they may be just as effective in treating heartburn and GERD. See the resources section below for books and websites about these diets, which have been used with dramatic success to treat everything from autism spectrum disorder (ASD) to Crohn’s disease.

Another alternative to very-low-carb that I increasingly use in my clinic is the low-FODMAP diet. FODMAPs are certain types of carbohydrates that are poorly absorbed by some people, particularly those with an overgrowth of bacteria in the small intestine (which, as you now know, tends to go hand-in-hand with heartburn). See this article and my book for more information.

Be careful to avoid the processed low-carb foods sold in supermarkets. Instead, I suggest a Paleo or ancestral approach to nutrition.

Fructose and Artificial Sweeteners

As I pointed out in Part II, fructose and artificial sweeteners have been shown to increase bacterial overgrowth. Artificial sweeteners should be completely eliminated, and fructose (in processed form especially) should be reduced.

Fiber

High fiber diets and bacterial overgrowth are a particularly dangerous mix. Remember, Almost all of the fiber and approximately 15 to 20 percent of the starch we consume escape absorption. (4) Carbohydrates that escape digestion become food for intestinal bacteria.

Prebiotics, which can be helpful in re-establishing a healthy bacterial balance in some patients, should probably be avoided in patients with heartburn and GERD. Several studies show that fructo-oligosaccharides (prebiotics) increase the amount of gas produced in the gut. (5)

The other problem with fiber is that it can bind with nutrients and remove them from the body before they have a chance to be absorbed. This is particularly problematic in GERD sufferers, who may already be deficient in key nutrients due to long term hypochlorydria (low stomach acid).

H. pylori

In Part III we looked at the possible relationship between H. pylori and GERD. While I think it’s a contributing factor in some cases, the question of whether and how to treat it is less clear. There is some evidence that H. pylori is a normal resident on the human digestive tract, and even plays some protective and health-promoting roles. If this is true, complete eradication of H. pylori may not be desirable. Instead, a low-carb or specific carbohydrate diet is probably a better choice as it will simply reduce the bacterial load and bring the gut flora back into a state of relative balance.

The exception to this may be in serious or long-standing cases of GERD that aren’t responding to a very-low-carb or low-carb diet. In this situation, it may be worthwhile to get tested for H. pylori and treat it more aggressively.

Dr. Wright, author of Why Stomach Acid is Good For You, suggests using mastic (a resin from a Mediterranean and Middle Eastern variety of pistachio tree) to treat H. pylori. A 1998 in vitro study in the New England Journal of Medicine showed that mastic killed several strains of H. pylori, including some that were resistant to conventional antibiotics. (6) Studies since then, including in vivo experiments, have shown mixed results. Mastic may be a good first-line therapy for H. pylori, with antibiotics as a second choice if the mastic treatment isn’t successful.

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Replace Stomach Acid, Enzymes and Nutrients That Aid Digestion and Are Necessary for Health

HCL with Pepsin

If you have an open-minded doctor, or one that is aware of the connection between low stomach acid and GERD, ask her to test your stomach acid levels. The test is quite simple. A device called a Heidelberg capsule, which consists of a tiny pH sensor and radio transmitter compressed into something resembling a vitamin capsule, is lowered into the stomach. When swallowed, the sensors in the capsule measure the pH of the stomach contents and relay the findings via radio signal to a receiver located outside the body.

In cases of mild to moderate heartburn, actual testing for stomach acid production at Dr. Wright’s Tahoma clinic shows that hypochlorydria occurs in over 90 percent of thousands tested since 1976. In these cases, replacing stomach acid with HCL supplements is almost always successful.

Although testing actual stomach acid levels is preferable, it is not strictly necessary. There is a reasonably reliable, “low-tech” method that can be performed at home to determine whether HCL supplementation will provide a benefit.

To do this test, pick up some HCL capsules that contain pepsin or acid-stable protease. HCL should always be taken with pepsin or acid-stable protease because it is likely that if the stomach is not producing enough HCL, it is also not producing enough protein digesting enzymes.

Note: HCL should never be taken (and this test should not be performed) by anyone who is also using any kind of anti-inflammatory medication such as corticosteroids (e.g. predisone), aspirin, Indocin, ibuprofen (e.g. Motrin, Advil, etc.) or other NSAIDS. These drugs can damage the GI lining that supplementary HCL might aggravate, increasing the risk of gastric bleeding or ulcer.

To minimize side effects, start with one 650 mg capsule of HCL w/pepsin in the early part of each meal. If there are no problems after two or three days, increase the dose to two capsules at the beginning of meals. Then after another two days increase to three capsules. Increase the dose gradually in this stepwise fashion until you feel a mild burning sensation. At that point, reduce the dosage to the previous number of capsules you were taking before you experienced burning and stay at that dosage. Over time you may find that you can continue to reduce the dosage, or you may also find that you may need to increase the dosage.

In Dr. Wright’s clinic, most patients end up at a dose of five to seven 650 mg capsules. In my experience, this dose is too high for many people. In fact, some have trouble with even a single 650 mg capsule. I’ve also found that the addition of cholagogues (agents which promote bile flow from the gall bladder into the small intestine) and pancreatic enzymes can help tremendously, especially in the initial stages.

While I previously recommended a combination of HCL and enzymes called the AdaptaGest Duo, those supplements are no longer available. I now recommend Betaine HCL/Pepsin by Thorne Research and Super Enzymes by Now. 

Bitters

Another way to stimulate acid production in the stomach is by taking bitter herbs. “Bitters” have been used in traditional cultures for thousands of years to stimulate and improve digestion.

More recently, studies have confirmed the ability of bitters to increase the flow of digestive juices, including HCL, bile, pepsin, gastrin and pancreatic enzymes. (7)

Unsurprisingly, there aren’t many clinical studies evaluating the therapeutic potential of unpatentable and therefore unprofitable bitters. However, in one uncontrolled study in Germany, where a high percentage of doctors prescribe herbal medicine, gentian root capsules provided dramatic relief of GI symptoms in 205 patients.

The following is a list of bitter herbs commonly used in Western and Chinese herbology:

  • Barberry bark
  • Caraway
  • Dandelion
  • Fennel
  • Gentian root
  • Ginger
  • Globe artichoke
  • Goldenseal root
  • Hops
  • Milk thistle
  • Peppermint
  • Wormwood
  • Yellow dock

Bitters are normally taken in very small doses—just enough to evoke a strong taste of bitterness. Kerry Bone, a respected Western herbalist, suggests five to 10 drops of a 1:5 tincture of the above herbs taken in 20 mL of water.

An even better option is to see a licensed herbalist who can prescribe a formula containing several of the herbs above as appropriate for your particular condition.

Apple cider vinegar, lemon juice, raw (unpasteurized) sauerkraut and pickles are other time-tested, traditional remedies that often relieve the symptoms of heartburn and GERD. However, although these remedies may resolve symptoms, they do not increase nutrient absorption and assimilation to the extent that HCL supplements do. This may be important for those who have been taking acid suppressing drugs for a long period.

It is also important to avoid consuming liquid during meals. Water is especially problematic, because it literally dilutes the concentration of stomach acid. A few sips of wine is probably fine, and may even be helpful.

Finally, for those who have been taking acid stopping drugs for several years, it may be necessary to replace the nutrients that are not absorbed without sufficient stomach acid. These include B12, folic acid, calcium, iron and zinc. It’s best to get your levels tested by a qualified medical practitioner, who can then help you replace them through nutritional changes and/or supplementation.

Restore Beneficial Bacteria and a Healthy Mucosal Lining in the Gut

Probiotics

Because bacterial overgrowth is a major factor in heartburn and GERD, restoring a healthy balance of intestinal bacteria is an important aspect of treatment.

Along with performing several other functions essential to digestive health, beneficial bacteria (probiotics) protect against potential pathogens through “competitive inhibition” (i.e. competing for resources).

Researchers in Australia have shown that probiotics are effective in reducing bacterial overgrowth and altering fermentation patterns in the small bowel in patients with IBS. (8) Probiotics have also been shown to be effective in treating Crohn’s disease, ulcerative colitis, and other digestive conditions. (9)

Probiotics have also been shown to significantly increase cure rates of treatment for H. pylori. (10) In my practice I always include a probiotic along with the anti-microbial treatment I do for H. pylori.

I am often asked what type of probiotics I recommend. First, whenever possible I think we should always attempt to get the nutrients we need from food. This is also true for probiotics. Fermented foods have been consumed for their probiotic effects for thousands of years. What’s more, contrary to popular belief and the marketing of commercial probiotic manufacturers, foods like yogurt and kefir generally have a much higher concentration of beneficial microorganisms than probiotic supplements do.

For example, even the most potent commercial probiotics claim to contain somewhere between one and five billion microorganisms per serving. (I say “claim” to contain because independent verification studies have shown that most commercial probiotics do not contain the amount of microorganisms they claim to.) Contrast that with a glass of homemade kefir, a fermented milk product, contains trillions of beneficial microorganisms!

What’s more, fermented milk products like kefir and yogurt offer more benefits than beneficial bacteria alone, including minerals, vitamins, protein, amino acids, L-carnitine, fats, CLA, and antimicrobial agents. Studies have even shown that fermented milk products can improve the eradication rates of H. pylori by 5 to 15 percent. (11)

The problem with fermented milk products in the treatment of heartburn and GERD, however, is that milk is relatively high in carbohydrates. This may present a problem for people with severe bacterial overgrowth. However, relatively small amounts of kefir and yogurt are therapeutic and may be well tolerated. It’s best to make kefir and yogurt at home, because the microorganism count will be much higher. Lucy’s Kitchen Shop sells a good home yogurt maker, and Dom’s Kefir site has exhaustive information on all things kefir. If you do buy the home yogurt maker, I suggest you also buy the glass jar that Lucy’s sells to make it in (rather than using the plastic jar it comes with).

If dairy doesn’t work for you, but you’d like to get the benefits of kefir, you can try making water kefir. Originating in Mexico, water kefir grains (also known as sugar kefir grains) allow for the fermentation of sugar water or juice to create a carbonated lacto-fermented beverage. You can buy water kefir grains from Cultures for Health.

Another option is to eat non-dairy (and thus lower-carb) unpasteurized (raw) sauerkraut and pickles and/or drink a beverage called kombucha. Raw sauerkraut can easily be made at home, or sometimes found at farmer’s markets. Bubbies brand raw pickles are sold at health food stores, as is kombucha, but both of these can also be made quite easily at home.

All of that said, probiotic supplements are sometimes necessary and can play a crucial role in treatment and recovery.

But not all probiotics are created alike, and in the case of small intestinal bacterial overgrowth (or SIBO, which is commonly present with GERD), certain probiotics may make things worse. SIBO often involves an overgrowth of microorganisms that produce a substance called D-lactic acid. Unfortunately, many commercial probiotics contain strains (like Lactobacillus acidophilus) that also produce D-lactic acid. That makes most commercial probiotics a poor choice for people with SIBO.

Soil-based organisms do not produce significant amounts of D-lactic acid, and are a better choice for this reason. I recommend the Daily Synbiotic from Seed.

Bone Broth and DGL

Restoring a healthy gut lining is another important part of recovering from heartburn and GERD. Chronic stress, bacterial overgrowth, and certain medications such as steroids, NSAIDs and aspirin can damage the lining of the stomach. Since it is the mucosal lining of the stomach that protects it from its own acid, a damaged stomach lining can cause irritation, pain and ultimately, ulcers.

Homemade bone broth soups are effective in restoring a healthy mucosal lining in the stomach. Bone broth is rich in collagen and gelatin, which have been shown to benefit people with ulcers. (12) It’s also high in proline, a non-essential amino acid that is an important precursor for the formation of collagen. Bone broth also contains glutamine, an important metabolic fuel for intestinal cells that has been shown to benefit the gut lining in animal studies. (13) For more on the healing power of bone broth, see my article “The Bountiful Benefits of Bone Broth: A Comprehensive Guide.”

Although I prefer obtaining nutrients from food whenever possible, as I explained above, supplements are sometimes necessary—especially for short periods. Deglycyrrhizinated licorice (DGL) has been shown to be effective in treating gastric and duodenal ulcers, and works as well in this regard as Tagamet or Zantac, with far fewer side effects and no undesirable acid suppression. (14) In animal studies, DGL has even been shown to protect the stomach lining against damage caused by aspirin and other NSAIDs. (15)

DGL works by raising the concentration of compounds called prostaglandins, which promote mucous secretion, stabilize cell membranes, and stimulate new cell growth—all of which contributes to a healthy gut lining. Both chronic stress and use of NSAIDs suppress prostaglandin production, so it is vital for anyone dealing with any type of digestive problem (including GERD) to find ways to manage their stress and avoid the use of NSAIDs as much as possible.

When Natural Treatments May Not Be Enough

There may be some cases when an entirely natural approach is not enough. When there is tissue damage in the esophagus, for example, a surgical procedure called “gastroplication” which repairs the LES valve may be necessary. These procedures don’t have the potential to create nutrient deficiencies and disease the way acid blockers do. It is advisable for anyone suffering from a severe case of GERD to consult with a knowledgeable physician.

Conclusion

The mainstream medical approach to treating heartburn and GERD involves taking acid stopping drugs for as long as these problems occur. Unfortunately, because these drugs not only don’t address the underlying cause of these problems but may make it worse, this means that people who start taking antacid drugs end up taking them for the rest of their lives.

This is a serious problem because acid stopping drugs promote bacterial overgrowth, weaken our resistance to infection, reduce absorption of essential nutrients, and increase the likelihood of developing IBS, other digestive disorders, and cancer. The manufacturers of these drugs have always been aware of these problems. When acid-stopping drugs were first introduced, it was recommended that they not be taken for more than six weeks. Clearly this prudent advice has been discarded, as it is not uncommon today to encounter people who have been on these drugs for decades—not weeks.

What is especially disturbing about this is that heartburn and GERD are easily prevented and cured by making simple dietary and lifestyle changes, as I have outlined in this final article.

Unfortunately, the corruption of our “disease-care” system by the financial interests of the pharmaceutical companies virtually guarantees that this crucial information will remain obscure. Drug companies make more than $7 billion a year selling acid suppressing medications. The last thing they want is for doctors and their patients to learn how to treat heartburn and GERD without these drugs. And since 2/3 of all medical research is sponsored by drug companies, it’s virtually guaranteed that we won’t see any large studies on the effects of a low-carb diet on acid reflux and GERD.

So once again it’s up to us to discover the truth and be our own advocates. I hope this series of articles has served you in that goal.

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1,156 Comments

Join the conversation

  1. So, it sounds like one should increase acid for GERD, but it almost sounds like the opposite for what is termed “silent reflux”. I have not been diagnosed, but suspect I may have the silent reflux. Afraid to see a doc, as I don’t want to just be given a pill! Any thoughts?

  2. I am suffering from gerd since last 2 to 3 years, used to eating high carbohydrate diet. Has taken lot of antcids, ppi, and psychitric medicine.
    Today was first day of only protein diet, no symptoms of gerd, only severe headache , but dared to take paracetamol with only sucralfate, and result ? No symptoms even after nsaid. Let’s see, what happens tomorrow.

  3. Hi, After taking PPIs for about 10 years thanks to this website I finally decided to stop doing it. Surprisingly I didn’t feel as bad as I thought I would. Obviously I had some heartburns from time to time. However when I started watching what I eat, removed gluten products from my diet, cut down on sugar and stopped mixing different food groups on one plate most of my problems seems to disappear. In addition I even managed to loose some weight :-). There is only one problem I have that I can’t really sort out so far. About one week after I stopped taking PPIs I started having some burning sensations in my ears, nose and sinuses even when I didn’t have heartburns. They seemed to get stronger and stronger and at some point I decided to take some PPIs to see if they could help. I felt better for couple of days and again after few days that burning came back. I googled those symptoms and found out this could be Laryngopharyngeal Reflux. Has anyone ever had the same problem and knows how to deal with it naturally without taking PPIs?

    • Hi, I’m Mary I am 14 years old I have had GERD for 6 years but for 4 of them it had been miss diagnosed as asthma. The doctors kept upping my dose of serious inhalers until I was on the highest adult dosage and taking seriod tablets. When I started my GCSES I became incredibly interested in biology and so for two years I kept saying I didn’t think I have asthma finally they did a spyromitary test and found out I didn’t have asthma. Also I had frequent stomach aches and my mum and nana both have coeliac disease so they took a biopsy but while passing through my oesophgus they saw my thoart was damaged blue due to repeated acid exposure. They gave me PPI’s but I have bad reactions to tablets and I got migraines and dizziness from them so they gave me the highest dosage of the next stage down. I am a keen runner but haven’t been able to do much sport without coughing up blood after, in too much pain to sleep and coughing in the morning, on the tablets. My doctor is going to take a test to see how much acid is in my stomach so I guess I’ll find out if it is due to too much or little stomach acid.

      • Are you doing any better? I have a 16 yo in track/soccer who constantly clears her throat and coughs after exercise. She does not have asthma. Her Doc wants to put her on Prilosec, which I’m against….says he’s 95% sure she has LPR. I hope you’re feeling better!

      • Dont eat white bread made with bleached flour or coffee, not even beans r safe, unless u grow it. Read wikipedia

    • I have the same situation stop taking Prilosec started getting burning sensation in throat nose been going on for a month or two Dr. put me on probiotics what do we do to get rid of the burning sensations

    • Taking flaxseed meal and cleaning ear wax more frequently helped reduce the burning sensation in the throat, ears . They told me it is hot flushes and told me to take Remifemin …I opted to take flaxseed instead.

    • That’s a rebound effect of PPIs. Our pharmacist gave us a quick education that these medications are supposedl to be taken for two weeks only. Since it is very helpful in masking the symptoms (reflux, bloating, etc.), people will stay for as long as they can. Thus when you stop, the rebound effect kicks in (again: reflux, bloating, etc.).

      It’s my 5th day of having palpitations and mild chest discomfort, waited for an hour for an MD only to be checked for 10 mins. Prescribed with Pantoprazole and off I go to the world.

      It’s just so depressing how traditional medicine will just “treat” the disease and mask the symptoms. Of course, doctors will place us on PPIs and H2As so long as we’re comfortable and we’re out of their office in 10 mins.

      Oh and btw, I’m a nurse.

  4. I have a question. It all comes to the point that the main reason for digestive problems is low acid level in the stomach. Would that not be logical to go further and ask what causes the low acid production in the first place? Is taking HCL, pepsin etc forever not the same type of solution as taking PPIs and similar? Would that not be better to cure the cause instead taking more supplements and medication? I would love to hear some opinions.

    • I have similar questions for Chris as well. Maybe he can produce another ebook regarding life after stopping ppi’s successfully.
      I was on omoprazole 2 years, bought Chris’s HCL and enzymes and really got strict with my diet following everything he suggested.. Yes, I Am Healed! Thank you SO much, Chris!
      …………and now, how long do I stay with the supplements? I have introduced some of my faves that aren’t on my new program and have no problems. But I am careful not to vear too far away from the diet. I can do that for the rest of my life, but should I start weaning off of the HCL and enzymes?

      • Acid secretion reduces with age.
        H. pylori overgrowth can also reduce it.

        After using supplemental HCl for a while (about 4 weeks, IIRC), your own HCl production should increase . So there’s no need to take it in the long term.

        Although with the reduction due to aging, I guess it could be necessary to repeat the protocol at some future stage.

      • What diet did you follow? I’ve been strict Paleo for ten years and have recently been diagnosed with Barrett’s Esophagus. Would love to know what you ate to heal yourself. I’m not having any success getting rid of the pain with the antacid meds and taking myself off, but need to make sure this doesn’t develop into cancer.

        • I have recently started drinking ETERNAL WATER which is a naturally alkaline pH balanced water. It’s on sale Buy One Get One Free at Publix this week! I’ve been drinking it over a month, and that’s the only water I drink, and it makes my stomach feel great, and my heartburn is nearly gone! I am using several different probiotics daily and drinking Good Belly juice, too. I’m drinking two tablespoons of Bragg’s Apple Cider Vinegar in six oz of Eternal Water along with a teaspoon of Manuka Honey three times a day. There are days now where I have NO SYMPTOMS!!! Occasionally, I have to take a couple of Rolaids or Tums, but after decades on Omeprazole and horrible withdrawal symptoms in the first few weeks, finally I see the light at the end of the tunnel! Keep the faith!

      • Before you began this did you know your acid levels or not? And before you got cleared up did your esophagus feel like it had acid. Because I’m thinking about trying this. Please reply.

  5. I have really bad breath, I can taste it and smell it when I open my mouth it is that bad. I think it could be gerd. I cough and feel like I have something in my throat sometimes.

    For the last two years I have cooked all my food from scratch, bake homemeal bread do not have takeaway food. I use coconut oil, olive oil and after learning about cooking oils I render my own lard and use that for cooking. I eat I though really good. I have fresh lemon juice with cider vinegar and a teaspoon of honey then breakfast is porridge, weetabix or egg. Lunch is a sandwich, honemade soup or pasta tuna or spinach. Evening I have meat normally chicken, turkey, I have added liver once a week and pork rib with vegetables broccoli carrots spinach. I even make bone broth I thought that was good for the stomach.

    I do not know what else to do now any ideas?

    • I had a bad case of silent reflux (causing my throat to close up) which may be behind your cough and feeling that something is in your throat. I was drinking diluted lemon juice daily for several years to prevent more kidney stones, but stopped after discovering the effects of acidic foods on lpr. Dr. Jamie Koufman, ENT, in her book Dropping Acid discusses using a low acid diet to minimize additional damage from acid going down, on top of acid coming up into the throat, and other ways to limit lpr-acid reflux up into the larynx. She starts with foods with ph 5 and above, followed by maintenance on ph 4 and up foods, with easy charts and recipes. I was also using ph strips to test for low acid foods (see Susan Fred’s post below:) I am much better now, and do still use bone broth, as well as many of Chris Kresser’s suggestions for gut healing. Hope you find relief!

    • I have the same problem suffering for 22 years it has ruined my life I can’t go near people fearing the embarrassment of bad breath.

      I have constant horrible taste back of my throat severe heartburn, very dry mouth, white tongue. I have been on acid reflux medication nothing helped…

      • Try using the ‘tung brush’ with ‘tung gel’ — this will clean your tongue better than a standard metal tongue scraper.

        Also use ‘smart mouth’ mouthwash.

        Dry mouth will also lead to bad breath. Try to keep it hydrated with water or biotene moisturizing mouth spray.

        Do you have tonsil stones? This will also cause bad breath.

        Best of luck.

    • I used to have very bad breath too. My cure is eating yogurt and kefir, but unsweetened, once or twice a day. Rince mouth with baking soda in water, and brush with baking soda. This works for me. Also, if you eat cheese often (this helped my daughter when she was 4), try cutting it out for a while. Eat leafy greens.

    • Try cutting out gluten: bread, pasta, porridge, Weetabix, burger buns, pizza etc: (all full of gluten) for a month or two and see if you feel better.

      You can still make your own cloud bread out of just eggs and cream cheese or mashed cottage cheese. Google for recipes, there are tons out there. (Works great for sandwiches, burgers, or make a larger one for pizza/flatbread etc).

      And try a spiralizer (plenty of different types on Amazon etc ) to turn squash/marrow and/or courgette/zucchini into noodles to replace pasta. Again, works great for me.

      I don’t miss any of that gluten filled garbage any more (was making me very sick, doing much better without it in my diet now).

  6. I have been taking 30 mgs prevacid for six years for what was occasional heartburn and was never warned, tested, or anything! I am shocked that I was given this drug. The heartburn was from weight gain. I have lost the weight. I am experiencing side effects of this terrible drug and want off of it ASAP. I use goodbelly probiotic, dgl, etc. How do I get off this drug? My NP suggested 25% reduction per week. Why did they do this to me?

  7. Hello,
    In the past three months I’ve been feeling something unusual. Whenever I am stressed or nervous I get severe stomach pain, mostly in my pancreas. This pain won’t go until everything is back in normal. Sometimes, even if I am not stressed or nervous, I feel the same pain. Is this acid reflux? I’ve made all this blood test, ultra sounds and they found nothing. Everything was perfect, my blood is excellent, there is no H. pylori, nothing at all. Any suggestions? Thanks

  8. Hi,
    I have been hoarse for the past 6 weeks already! including chest and throat pain. I went to an ENT and he put something down my throat to check and said i have calluses on my throat and must have been an infection also which caused me to have acid reflux which then caused my hoarseness. I am about 10 weeks pregnant now and I don’t know what to take or what to do. All my doctors, regular and ob are giving me lists of antacids to take. What do i do? From reading all these comments, im scared to take the meds but what is the other option? i do have burning in my chest and sometimes throat from various foods that i eat, even the ones that are not the well known acidic foods. I can’t have an endoscopy at this time as i have to be careful with what goes into me. any suggestions would be greatly appreciated. I have had a small occurence of this prior to my pregnancy, so i dont feel its pregnancy related.
    Any suggestions would be greatly appreciated!! I don’t know where to go or who to turn to?

    • Hi TM, how wonderful it is that you are so conscientious about your health and the health of your baby at a young age. I didn’t follow that path, and at nearly 55, I’m suffering for it. I share the hoarseness and have acid burns on my throat. I was prescribed omeprazole in the morning and ranitidine at night, which was to be taken for 3 months at least, and I’m not doing that. FIRST, I have found relief by avoiding offending foods. SECOND, I bought some pH paper and started testing what I was drinking and found so many things acidic, so I’ve limited those. THIRD, I pay attention to ingredients and watch for anything that contains an acid as a preservative (e.g., citric acid, which is in practically EVERYTHING!). FOURTH, I make homemade pH water by mixing a half teaspoon of organic baking soda with a half gallon of water. When I eat or drink something, I “flush” my throat by taking a sip of this water. I know that I wasn’t drinking enough water to begin with, and I’m sure that made things worse. FIFTH, consider checking out the basic blood type diet and see if sticking with those foods start making you feel a bit better. SIXTH, everything in moderation! Eat balanced smaller meals throughout the day and refrain from eating after 6 pm. SEVENTH, consider trying guided meditations or yoga to reduce stress, which is detrimental to health and well-being. Providing a calm environment for yourself will benefit both you and your baby. Learning to be calm in difficult situations and getting to know yourself deeply is life changing. Please let me know if I can offer you any support at this time. I’d be glad to do so! Susan

      • I just read your comment . I’ve been experiencing the worse no the most SEVERE form of heartburn- and I like what you explained. I was wondering what the ph paper is and where do you get it?

        • Hi Claudine! The pH paper that I have is by Pike Agri-Lab. I got it at my local health food store. They also have a Web site (pikeagri.com). It’s distressing to hear that you continue to have issues. Consider keeping a food journal in which you write down everything you eat and at what time, also noting when you have bouts of heartburn? That could be a real eye-opener. Also, I forgot to mention last time about elevating the head of your bed about 3 to 6 inches, which could help to keep any acid where it’s supposed to be. My most interesting find, though, was about how pepsin can hang out in the esophagus and then be reactivated by acid-causing foods and drinks, which led to my theory of flushing the throat with pH water after eating or drinking could be helpful. Hoping that you can find some relief soon, Claudine! Wishing you a lovely day, Susan

  9. Hi Dear Chris, I am here educating myself more about GERD and all the things around it. I was on few medications last years, and they were ok for few months. But I am the kind of person that like the most natural and not many 2nd effects as possible. I read your whole article. I just want to say thanks for sharing because it has helped me to clearly understand everything about my guts, GERD, diet, and natural ways to try lots of the available options. I liked the way you addressed this topic, you make it look so understandle for people like that know more about technical stuffs. I wrote down few steps to put into place starting right now. I started loving more few ingredients, vegetables and natural food that somehow I felt were doing great in my body. I see how every metabolism reacts so different and that we personally are the only one able to communicate what are body is trying to tell us. I will be rigorous at least this first next month, and see how it goes. You article and touchable way to connect with readers have been of so much value and surpasses few Drs. recommendations I have gotten in the 15-30mins they see me.
    I’m crazy, I just wanted to say Hi. And yes, let’s do more natural things, believe that we can, but the work. I got it.

    Hugs,
    Sol

  10. Is there any research on the mental status effects of PPI’s being able to be reversed? I’ve been on them for the last 20 years. The only reason I even came across this article is because I was concerned that I might be getting early onset dementia or Alzheimer’s. I’m only 45 and I’m scared to death because I’ve got serious short-term memory deficits. 🙁

    • there is no need to be afraid of getting alzheimers,in a book called AWAKENING FROM ALZIEMERS BY PEGGY SARIN there are 8 diferent cures,dont believe what the doctors tell you it can be cured..but the big pharmacutical companys dont want you to know this ..dont worry if you are just begining to foreget things try, VINPOCETINE 10mgs 3 times daily with food its amazing it will protect you from getting alzheimers,its good also for your eyes & hearing & will reverse tinitus,,get onto organic virgin coconut oil cook with it bake with it rub it into your skin put it on your hair,do not use hydroginated oils& magarines,,good luck ,,english jean…

      • Hi Jean what is VINPOCETINE and where do you purchase it. I have been on ppi’s for over ten years and i believe my tinnitus is a side effect from it along with other troubles

    • Hi Kate, I am Deepak from India. I am also taking PPI since 4 years and now my condition is even worse. Earlier it was only acid refluxe I was suffering from but now it has become chronic mental stress and headache. I can understand your position. I have started taking low carb diet as directed by Chris and there is a releif in headache and my memory. Although my GERD is chronic and I am not able to cure is fully with a low carb diet but it is helpful to reduce PPIs. Earlier I used to take 1PPI drug in three days now I take 1 PPI drug in 7-10 days.

      • Hi i had the same. Got well by stopping all bleached flour products, ie white bread and processed coffee. see wikipedia

    • Kate,
      I’m sorry to hear that you are going through this. This may help. I recently watched many of the lectures from last month’s Alzheimer’s and Dementia Summit where lecturers from all over the world address the causes and ways of reversing this disease. You can access these lectures at: http://alzheimersdementiasummit.com. Every lecture I saw was amazingly informative. I believe Sayer Ji may have covered this topic but I can’t be absolutely sure. It would be a worthwhile investment of your time and money to watch the lectures from this summit. I believe the cost is under $100.00. I’m certain you could contact one of the doctors located in the US to address your concerns. There names are provided. The one thing they all had in common was the realization that currently conventional drugs do not work. They provide many other helpful approaches. In addition, the following website provides a more natural way of addressing acid reflux: http://chriskresser.com/heartburn. I hope this will be helpful. Contacting a positive medical provider is key.

  11. Thanks for your great advice! I am considering taking HCL with pepsin to replace stomach acid, but is there any other way I can replace stomach acid on a permanent basis instead of having to pop a pill before a meal?

  12. “Three simple steps”, eh?

    Since I struggle with eating animal protein, I was interested in the alternative to VLC mentioned in this article. I just went to the GAPS introduction section and immediately started reading about… collecting animal body parts to make my own stock.

    This is very intimidating… especially for one who is a bit squeamish about eating animal protein in the first place–although I do force myself to do so…

    I wouldn’t consider any of these “three simple steps” to actually be …simple.

    I don’t look forward to weeks/months/a lifetime of trying to prepare and consume foods that don’t appeal to me at all. I can see why people simply give in and take the PPI (I’ve been on one for years). I’m concerned enough to try modifying my diet more than I already have… I do make sure I consume protein at every meal and usually abstain from sugar/white flour foods, plus I take digestive enzymes, but apparently this hasn’t been enough.

    I’m tired of the struggle, angry at the medical system that had me on years of antibiotics as a child (for chronic allergies/sinus/ear infections), and angry that this system also advocated for decades the high-carb low-fat diet–and here I am in this difficult situation as a result.

    Shees. Thanks for listening.

    • sauerkraut and kyo dophilus cured my severe GERD within 2 weeks.. try it… i promise it will work ..

        • Hope you will see this! It is just a certain kind of probiotic pill. You can get probiotics from fermented foods instead. There may even be fermented foods in your traditional way of eating. Just look up how to ferment foods at home or something like that. Good luck!

    • 1 glass of apple juice and mix with 1 teaspoon of braggs apple cider vinegar everyday is very effective. Eat more vegetable and high fiber diet. Use only canola and Olive Oil. Avoid spicy and fatty food.

    • Take DGL CHEWABKE TABLETS i been taking them for 2 weeks i feel great and not on nexium now and feeling so much better. Spread the word it works.

    • Please try DGL chewable tablets. I just started taking them 2 weeks ago they are helping me so much and I dont even have to take my nexium now. Please look look them up and you will see. I have polyps, sikent reflux, and LPR really bad. Right now i feel great.

    • Hi i had the same and went through hell. Got well by stopping all bleached flour products, ie white bread and processed coffee. see wikipedia
      If you get better with it help some one else too.

  13. Acid reflux has taken over my life. I have suffered from daily heartburn for the past 2 1/2 years and also get really dry mouth alongside this. I’m 22 and prior to symptoms my diet was awful and I overate a lot and I’ve never been overweight – 8 stone. Since January last year I transformed my diet, first cutting out gluten, then dairy free, then strictly paleo and now meat free and only fish, pulses etc. I have spent thousands of pounds working alongside a herbalist, messing with my diet, take a host of different herbal mixes – slippery elm, marshmallow, meadowsweet etc & tried HCL & betaine which caused so much pain from just one tablet. I take digestive enzymes and probiotics with every meal and only eat organic foods. Been testing by doctors for every possible problem, endoscopy etc – all clear. I’m at a point now where I’m giving up fish also, just to see what happens but it can just be soul-destroying and limiting at a young age where everyone is eating out, drinking, enjoying their life and I’m stuck with this problem. The doctors have told me the solution is medication for life but I’ve done so much research into the negative effects I can’t bring myself to do it, so just ride through the pain. My symptoms begin to improve over a few days & I think I might have finally found the answer but then it worsens again. I just feel like I’m running out of options here, shouldn’t a year of eating this purely and taking all the right things be paying off now? I’m just scared it will only get worse as I age. (I’ve tried all the steps in this article)

    • sauerkraut and kyo dophilus cured my severe GERD within 2 weeks.. try it… i promise it will work ..

      • Can you please tell me if Gerd has not returned for you. I am using aloe vera juice and it seems like it is helping. I no longer eat meat and am trying to be vegan almost there but cant get off the eggs. I also eat as much organic products when I buy my food.
        How do I take what you took that you said cured your GERD cause I was told Gerd was not curable only treatable.

    • 1 glass of apple juice and mix with 1 teaspoon of braggs apple cider vinegar everyday is very effective. Eat more vegetable and high fiber diet. Use only canola and Olive Oil. Avoid spicy and fatty food or maybe you have gallstones.

    • Have you tried working with a naturopath and/or someone who is adept at diagnosing by the use of kinesiology (muscle testing), and/or someone who works with emotional components of dis-ease (possibly EFT, or emotional freedom technique/tapping)? (It couldn’t hurt to search for these things in your area….)

    • I read about an american man who had masivly painfull acid reflux for 25 years, then he found out “by accident” that 1 slice of an apple took it away in miutes,try it what have you got to lose..from my research it is looking more & more as if the bugs in your gut have a big influence on digestive problems..i tried the PRISCRIPT ASSIST pto-biotics from goodhealthnaturally.they are amazing,did you know by the time you are 70 you have lost 75% of your stomach acid,,i take a HCL with pepsin with every protein meal + a digestive enzyme tablet & i never get acid reflux anymore good luck english jean

    • Hi Charlotte,
      Sorry to read about your condition. I’m in my early 30’s and acid reflux had taken over my life for the past 2 years as well. Just like you, I was unwilling to take lifelong medication as an answer. So I set out in this effort and tried several different things. Now I am completely free of heartburn for the last 3 months. I still have mild reflux that is very manageable.
      These are the things that helped: 1) Switching to a low-carb diet (My heartburn went down to almost zero in 2 weeks but I followed strict low card avoiding high carb fruits, nuts, veggies). 2) I take digestive enzymes (Xymozyme) with every meal. 3) I take Probiotic Florastor (saccharomyces boulardii lyo) once a day after breakfast. 4) Last but not the least, I take SERRAPEPTASE – it is truly the miracle enzyme that has made me feel normal after 2 whole years of suffering by reducing the inflammation in the lining of my stomach. This medication has to be taken empty stomach.
      These were all suggested by a group called “Your future health”. They have been very helpful in trying to figure out my reflux. Please feel free to ask me any questions.

      • Hi Nowsheen,

        Sorry for the delayed response, I wasn’t notified of your response. How are you now?

        I still suffer daily. In Jan this year I gave up on everything I have been doing and returned to eating ‘normal’ I feel equally bad to when I did low carb etc. One thing I didn’t try was avoiding low carb fruits/vegans and my enzymes a probiotics contain none of these ingredients. Is there a brand you would recommend/a set diet you followed and do you still take all these and follow this now? I find it difficult cause my new job involves events and stop overs in hotels and require to eat out often, I’m miserable and have been for the whole of my early 20’s.

        Thanks for your advice I’m interested in exploring these supplements if they have worked for you

  14. I’m not sure if I have GERD, I assume I do. What I have been diagnosed with is a loose LES and am taking 40MG of Omeprazole/day. A colonoscopy also reviewed a few MAST Cells in my colon. I now am on a probiotic, 6 Metamucil and a generic anti diarrhea pill/day to control AM diarreha.
    I am willing to go on any diet but am wondering if I’ll be able to absorb the proper bacteria and nutrients. So should start by having the LES surgery, get off the Omeprazole, and then start to work on gut health. Thank you in advance.

  15. I went off PIPs 10 days ago cold turkey after 20 years (Nexium for last 12+). The reflux has been horrific. I started taking the HCL with pepsin 600 mg 4 days ago, increasing the number of pills, I’m at 3 right now and still having reflux, heartburn and bloating constantly. Would that mean too little or too many hcl pills?

    • Please try DGL chewable tablets they really work i was on all them pills too nexium ranitadine protonix everything u name it i took it. My esophagus is red and tightens up too sometimes making food hard to swallow. I have a lot of polyps too cause by them pills. Please try the chewable tablets look them up on amazon and also drink alkaline water too. ITS WORKING! I feel so much relief and better. Make sure you change your diet too.

      • Lisa I am scared to death. Had reflux for years but Drs say it’s not bad. Had an endoscopy they say not too bad. They stretched my esophagus and I still feel like I have a lump in my throat my swallowing is awful and milt reflux symptoms are back. I’m going to try this thank you!

        • I had the same for a year n was on ppi. Check if u also eat white bread made of bleached flour and drink processed coffee. Im way better and not on drugs except for occstional zanitac if i accidentally eat something. Its all in what we eat.

    • You can also try GB-3 by Endomet Labs/Analytical Research Labs. It’s similar to what Chris recommends above in that it has ox bile, pancreatin and black radish. I think I heard of it here in the comment section when I stopped using PPIs after many years. Using betaine/ACV/DGL wasn’t working at all, but GB-3 worked like a charm. Getting ready to order it again since my IBS symptoms have come back now that I stopped taking it. For more info, look up Dr. Wilson’s article on GB-3. Good luck, I hope your symptoms subside.

  16. Hi! Today, I received a diagnosis of silent reflux. The doctor said that I have acid burns in the throat as well. I was given prescriptions for Prilosec (to take in the morning) and Zantac (to take at night) and was told that it might take 3 months for the acid burns to clear up. In light of the negative effects of these drugs, would it be harmful to use a more holistic approach to clearing this, or maybe do a half and half approach (take the drugs for a month or until the major discomfort wanes while making dietary/lifestyle changes)? Any thoughts? I appreciate any comments. Susan

    • Yes please try a holistic approach. Right now I am trying Aloe Vera juice read up about it before you try. I have GERD, esophagitis, LPR too I am so sick of the pills these doctors give I am trying to stay away from them besides the doctors.
      I am also changing my diet to become Vegan one day soon I don’t eat meat I just cant get off the eggs. Read about that too it would be so much healthier.

      • I changed to DGL chewabke tablets and they are working. Please read about them. You can purchase through amazon of your local health food store.

    • Don’t drink that medicine it can cause a lot of side effects like gallstones and cholecystitis. Drink cabbage juice or 1 glass of apple juice and mix with 1 teaspoon of braggs apple cider vinegar everyday is very effective. Eat more vegetable and high fiber diet. Use only canola and Olive Oil. Avoid spicy and fatty food or maybe you have gallstones that cause acid reflux.

    • Please try DGL chewable tablets. I just started taking them 2 weeks ago they are helping me so much and I dont even have to take my nexium now. Please look look them up and you will see. I have polyps, sikent reflux, and LPR really bad. Right now i feel great.

  17. Thanks for the useful information.
    In my case i have problem of acidity since childhood (now i am 28) and usually eaten food comes back to my mouth, and if it is more severe than in vomiting sour liquid comes out. Recently i started feeling more acidity than usual and started feeling choking(lump) in my throat. I went to doctor who did endoscopy and found eosinophilic esophagitis. He has been giving me some medicines but i don’t see any improvement. There isn’t any problem of H.pylori.
    Can you suggest me eosinophilic esophagitis is problem because of high acid or low acid content in stomach?

    • Hi this exact thing happened to me too buy I was never told whether it was too much acid or too litlle. He just told me no caffeine, chocolate, peppermint. Did you get any responses back?

      • Its not the coffe. Its how they extract coffee beans with a chemical. Plus bleached white bread flour.
        Im well now after finding this out. No more ppi hell.