More Evidence That GERD Is Caused by Bacterial Overgrowth
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More Evidence to Support the Theory That GERD Is Caused by Bacterial Overgrowth

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

Right after publishing yesterday’s article (The hidden causes of heartburn and GERD), I came across a new research (PDF) study hot off the presses that adds support to the theory that GERD is caused in part by bacterial overgrowth. Before moving on to my next planned article in the series, I want to take some time to review this study and discuss its implications.

Malekzadeh & Moghaddam performed a retrospective study to investigate the prevalence of GERD in patients with IBS and vice versa. The data comes from a very large number of patients (6,476). To my knowledge it’s the largest data set that has been reported about the overlap between GERD and IBS.

The authors found that 64% of IBS subjects studied also had GERD, whereas 34% of the GERD patients also had IBS. They also found that the prevalence of all functional symptoms (such as nausea, changes in bowel movement, headache, etc.) was higher in overlapping GERD and IBS subjects than the prevalence in GERD subjects without IBS or IBS subjects without GERD.

Implications of the Connection between GERD and IBS

What this correspondence suggests, of course, is exactly what I argued in the last article: that IBS and GERD may very well share a common etiology and underlying mechanism. From the conclusion:

This finding shows that in overlapping GERD and IBS, other functional abnormalities of the GI tract are also highly prevalent, suggesting a common underlying dysfunction.

The authors even speculate that the underlying cause may be an overgrowth of bacteria. Specifically, they mention H. pylori as a possible culprit. I think they’re on to something!

Assessing the role of H. pylori infection in GERD and IBS patients could be a target of future research, as in the present study the prevalence of H. pylori infection in GERD patients was found to be greater than in non- GERD patients.

The Role of H. Pylori in GERD

I believe that H. pylori infection plays a significant role in the pathogenesis of GERD and other digestive disorders.

H. pylori is the most common chronic bacterial pathogen in humans. Statistics indicate that more than 50% of the world population is infected. Infection rates increase with age. In general, the prevalence of infection raises 1% with every year of life. So we can expect that approximately 80% of 80 year-olds are infected with H. pylori.

Second, we know that H. pylori suppresses stomach acid secretion. In fact, this is how it survives in the hostile acidic environment of the stomach, which would ordinarily kill all bacteria. Treating an asymptomatic H. pylori infection with antibiotics increases stomach acidity and eradicating H. pylori with antibiotics improves nearly all patients suffering from hypochlorhydria.

Although it is commonly assumed that stomach acid production declines with age, recent studies suggest that the secretion of stomach acid doesn’t decrease with age and that the trend is actually to increase, especially in men.

However, this tendency for acid secretion to increase with age is completely nullified by the corresponding increase in H. pylori infection. Since the incidence of H. pylori infection increases with age, it follows that hypochlorhydria also increases with age.

Acid Suppressing Drugs Increase Risk of H. Pylori Infection

Perhaps most importantly for those taking acid suppressing drugs, researchers now believe that the initial infection with H. pylori can only take place when the acidity level in the stomach is decreased (albeit on a temporary basis). In two human inoculation experiments, infection could not be established unless the pH of the stomach was raised by use of histamine agonists. (1, 2)

If low stomach acid is a prerequisite to H. pylori infection, we might expect acid suppressing drugs to worsen current H. pylori infections and increase rates of infection. That’s exactly what studies suggest. Prilosec and other acid suppressing drugs increase gastritis (inflammation of the stomach) and epithelial lesions in the corpus of the stomach in people infected with H. pylori.

A 1996 article published in the New England Journal of Medicine followed two groups of people who were being treated for reflux esophagitis for a period of five years. One group took Prilosec (20-40 mg/day) and the other underwent surgical repair of the LES. Among those who had documented H. pylori infections at the start of the study and who were treated with Prilosec, the rate of atrophic gastritis increased from 59 percent at the beginning of treatment to 81 percent by the end of the study. Among those who had no atrophic gastritis at the beginning of the study, 30 percent of those who took Prilosec later developed it. By contrast, just 4 percent of the surgically treated group developed atrophic gastritis.

Another Vicious Cycle You’d Be Smart to Avoid

The connection between low stomach acid, h. pylori and acid suppressing drugs kicks off another nasty vicious cycle, similar to the one we discussed in the previous article.

Low stomach acid >>> heartburn >>> acid suppressing drugs >>> H. pylori infection >>> further reduction of stomach acid >>> chronic heartburn & GERD

The increased risk of H. pylori infection caused by acid suppressing drugs is especially significant because H. pylori infection is associated with a small but significant increase in the risk of stomach cancer.

I’ll have more to say about this in the next article.

As I mentioned in the last article, fermentation of malabsorbed carbohydrates produces hydrogen gas in the intestines. Hydrogen gas is the preferred energy source for H. pylori. Elevated levels of hydrogen gas are also associated with other nasty bugs such as Salmonella, E. coli and Campylobacter jejuni, the leading cause of bacterial human diarrhea illnesses in the world.

Excessive fructose, certain types of fiber and starch, and particularly wheat increase hydrogen production, and thus increase the risk of infection by H. pylori and other pathogenic bacteria. If you’d like to avoid heartburn, GERD and the many other unpleasant symptoms associated with bacterial overgrowth, it follows that you should minimize your intake of sugars, starches and grains.

In the next article we’ll examine the many important roles of stomach acid and the significant risks of long term hypochlorhydria.

243 Comments

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  1. Hello,

    Had three tests done recently for H.pylori as reason for HDL-P.

    Breath test – positive
    Blood test – positive for anti-bodies
    Stool test – negative

    one doctor says treat with quadruple antibiotic and another says don’t

    Any thoughts?

  2. I was diagnosed with GERD several years ago and told to take Omeprozole however that has never offered relief. I don’t now and never have had any heartburn only nausea and stomach discomfort…every night no matter what I eat. Am very confused as to what to do or not to do. Have consulted with several physicians and I am still getting the same answer…continue to
    take the Omeprozole which I will not do. Need some advice
    as to what to do.

    • Get yourself checked for gastroparesis via a 4-hour emptying study. I had the same symptoms – of course they put me on a PPI, which supposedly slows down the stomach even more – but that didn’t do anything for me.

      Until you see your doc, try getting on a low fat, low fiber, low FODMAP diet.

      • Thank you so much for leaving this comment. After seeing this I looked up Gastroparesis and it fit my symptoms to the tee. I never previously had reflux and used to be able to eat right before bed. Now, almost anything makes me sick on some days, and it comes and goes. I had jackhammer esophageal spasms 3 months ago, and just woke up 5 hours after eating a meal feeling like it was just sitting there. It explains the build up of bacteria. Thankfully I took Gut Shot Fermented Cabbage Juice and have recently found that it kills H. Pylori and can help relieve symptoms. It calmed my stomach down, along with a few episodes of Dr. Thorne 🙂 I am down to 104 pounds, and need to find food that doesn’t make me sick. Thank you! Cheers, Kari

    • Take probiotics
      Digestive enzymes
      Apple cider vinegar (with the mother), 1 teaspoon on 8 oz water or less if you can tolerate it, this helps a lot with gerd.
      Get tested for bacteria overgrowth in your gut.
      Get tested a 2nd time, because sometimes bacteria can be undetected.
      Avoid sugar, carbs, wheat, oats.

      The Point is that you dont have high acid production, in reality high acid is rare. Low stomach acid causes all kinds of digestive disorders.

      Think about it, low stomach acid + food, one hour later, fermented undigested left-over unbroken down particles in your stomach, comprimises the whole digestive operation. Your start getting gasy, excessive burping, farting, sour stomach, constipation, diarrhea, nausea, vomiting, everything you eat does not settle right.

      Do more research.
      Stay positive.
      Hope this helps

  3. Greetings all,

    I was diagnosed with GERD a month ago. Of course they put me on 40mg of Omeprazole. Then, they increased it to 80 mg everyday. I am having stomach cramps, chest cramps, back cramp, legs cramps and chest pain. I told the doctor that I noticed that my shortness of breath increases when I take the Omeprazole. Of course, he wanted me to continue to take it until my biopsy results came in. I’m being tested for H Pylori and Gastritis. Recently, I noticed numbness in my left arm. I have taken every exam possible (e.g. 2 stress test, pulmonary function study, chest x-rays, echocardiograms, ekg’s, etc.) all have turned out negative results. My blood pressure averages 110/75 and my pulse rate is 55. It has even dipped to the 40’s several times in the past couple of day’s. Also, my oxygen level intake is typically 97%. I’m thinking, I have to be the healthiest patient ever…lol. Also, I keep a journal to document my eating and symptoms. These past two months have been difficult and enlightening. I lost 20 lbs thus far and stopped drinking sodas. Also, I eat super healthy now. Hopefully, the 20 lb weight loss was due to the change of my eating habits versus a bacterial infection. I strongly recommend conducting your own research and obtaining multiple opinions. The medical industry is really quick to drug us up and never truly handle the root cause. Treating symptoms is a money maker and that’s the reality. Yes, there are a lot of kind hearted physician’s, but the majority operate out of the ignorance and tradition of their medical training. I mentioned a plant based substance and the doctor had no idea what I was talking about. I am thinking it would have taken one minute to search the net…lol. Hopefully, I will have my results tomorrow, but either way I will not allow this condition to dictate my life.

    • So what happened with the results.. I think have something very similar to you. I too just lost 20 lbs

    • I get this from low magnesium. You’re either on too much. Try to Decrease your dosage…I’m on rabeprazole and if I take it from a certain manufacturer this happens. I can only take kremers brand because the inactive ingredients are different from the others and don’t drop my levels! Try a different manufacturer and/or decreased dosage! Scary feeling!

  4. I was diagnosed with Crohn’s disease 2 years ago after having a colonoscopy and an endoscopy. At the same time they diagnosed me with acid reflux. Since then I’ve been on omeprazole/prilosec everyday. It fixed my acid reflux/heartburn. I ended up having surgery to remove part of my intestine that was too inflamed due to crohns and they promised I wouldn’t be bloated anymore and I’d have normal bowel movements. This surgery was done at Mayo clinic in april of 2014 and I’m more bloated than ever, and I still have diarrhea/loose stools literally every morning when I wake up and sometimes have 2- 4 bowel movements a day. I’ve tried treating for SIBO for 2 weeks straight, nothing changed. I’ve also tried several other types of medicines including ones to treat anxiety and depression and no luck. I notice most of the time my bowel movements are acidic, which brings me back to wonder if taking omeprazole/prilosec everyday is messing something up. I tried going a week without it, but I got really really bad heartburn/indigestion and had to get back on it. I’ve gone to my GI doctor every 3 months trying something but nothing EVER works, they just say it’s IBS. I’m 26 years old and it’s impacted my life in a huge way to where I’m afraid to travel and can’t eat hardly any foods without having an episode. I know it could be way worse, but it’s also becoming very costly as my insurance sucks.

    • Hey, I’m so sorry to hear about what’s you’ve gone through Eric S.
      I have Lyme disease, so I’ve been checking out a very unconventional therapy for immune problems (which chron’s is mainly an autoimmune issue), and I’m pretty amazed. It’s called advanced cell training. Basically, if aims to fix the bad behaviors if a faulty immune system. They’ve helped many get over Lyme, ms, autoimmune diseases, allergies, and all sorts of infections.

      Also, I’ve heard juice fasts and enema cleanses can be very healing to give the GI tract a break from solid food for a few weeks. Sounds a little extreme, but I’m just throwing out what I’ve geared in my own health journey.

      I also think probiotics are extremely important – especially ones with saccharomyces boulardii in it to combat leaky gut (most people get leaky gut, and it causes a plethora of issues). Candida can be a big issue too.

      I’m a 24-year old nurse, but since getting sick I’ve had to go the natural and alternative route, because classical medicine just isn’t helping my chronic issues. You may want to consider going the natural way. Even just doing some research on your own. The advanced cell training is very cheap. I know the financial burden of health issues…its the worst. I’m learning that there is way more than meets the eye in health problems and healing. You gotta get to the root cause. I don’t believe chron’s and autoimmune diseases are as incurable as doctor’s say.

      Prayers for you man!

      • Advanced cell training? Where is this? I have just recently been diagnosed gastroparesis and virtually no peristalsis in my gut with severe silent reflux. I’m 26 and they’re thinking it’s autoimmune/vagus related. Was just curious about the methods you’ve tried. I’ve been on ppi’s the past 6 months and itake just been a downward spiral.

    • Sorry to hear that man. I’ve been researching some solutions and mastic gum seems to help people with these issues. I tried prilosec and it messed up my whole system. What helped me initially was taking Betaine HCL. Apparently heartburn can be caused by both low stomach acid and high stomach acid. Doctors just assume that too much stomach acid is the problem when a lot of times that isn’t the case. Betaine HCL worked for me and I’m looking forward to trying mastic gum. The reviews on amazon show that it’s worked for a lot of people but I would research everything first. Hope that helps!

      • Precisely, especially if you have h. Pylori. I found this out but haven’t tried the HCL therapy yet. I’ve been suffering for two long. I was told I had an overgrowth of h. Pylori, but I didn’t think to look that up. I was put on a 5/500mg antibiotic treatment plus ppi that made me feel like death. I then broke down and looked all my symptoms and only found very little to indicate that Becatin HCL is the answer. I have it. I’m going to try it, and this gum everyones talking about. Just not sure if I should now… I just found out I’m pregnant and I dont want to harm the baby. But I guess h. Pylori would harm it more. 🙂 hoping for relief soon.

    • I also suggest reading the book Why Stomach Acid is Good for You by Dr. Wright. Very eye opening. Best of luck!

  5. You may think my suggestion here is not relevant but I have suffered LPR (Silent reflux) for 2 years and after trials of all ppi etc medications, also diet restrictions. I accepted that I would just have to put up with it. I was not in pain but it became very embarassing when in company I felt like an aerosol coming up my throat and affecting my speech and confidence. Ppi’s did not really work, some gave temporary relief. In last few weeks I have taken Kefir, a fermented milk that contains 20 times healthy strains of bacteria than yogurt and my problem appears to have resolved. Perhaps for some of you could benefit from trying this approach if you suspect a bacterial infection attributing to your stomach discomfort. Worth a try as I have been searching for a cure for over two years. Plenty information on the web. I hope you all find a solution and get some comfort.

  6. I have been dealing with stomach pain and problems since I was 22 and I am currently 28. Things started as a nawing pain in my stomach all the time, that progressed into constant heartburn and indigestion. I was on prilosec on and off for years, my family doctor was treating me. Then it became horrible! Constant burning in my stomach,throat, and chest as well has having bowel movements of stomach acid and bile. I finally went to the er after my doctor refused to send me to a specialist. I was referred to a GI, and he began to treat me, not checking me prior to medicating me, all he did was prescribe a higher dose of prilocet. After 7 months of no change he did a colonoscopy,endoscopy and found 3 ulcers and many polyps in my throat,stomach and colon. Test came back positive for H.polyri. I took powerful antibiotics for 2 weeks! Now 4 years later I’m in even worse shape than before! I’m always belching 50+ times a day! Very unpleasant and painful,as well as gerd,gastritis, acid reflux,IBS that changes from diahrea to constipation. I’ve just recovered from 8 ulcers in my stomach and intestines and had a mas removed from my pancreas. My teeth are being damaged but stomach acid sitting in my mouth at night. Ive passed out from muscle spasms in my lower intestines,became flushed,shaking and in extreme pain. Doctor cant explain why im having these spasms. At times I have bloody stools or tary stools.I’m weak all the time,tired but have a hard time sleeping,not able to gain weight and my doctor says I’m fine. I have days where I can’t eat from bloating,pain or smelling food makes me nauseous, and when I discuss this he says you’ll be fine 2-3 days without eating! I feel that I’m at my whits end with doctors medicating without fixing the underlying cause! Can anyone offer anything that might help me? Thank You in advance 🙂

    • Try eating no sugar, no yeast, no fruits, no tomato sauce, spices, diary for two months. It cured my ibs and heartburn. It seemed my previous high intake of sugary foods and fruits caused Candida of the stomach and after strict regime on this diet plus fennel tea and Threelac supplement I was cured. Slowly I started to eat all the foods again, even chocolates and sweets (not too often) and it has been fine for 8 years now! I swear it is true

      • Jasna,

        Just wondering what your meals were when you went on that diet. Thanks for your time. Like what you ate for breakfast and what not.

      • Also wondering what kind of diet you were having during those 2 months. Sometimes it seems to me like everything I eat is bad except for some veggies… but I’m already losing too much weight. 🙁

        • When I read your comment, I can’t help but remember reading Jay Kordich’s book, called “The Power of Juicing”. He is the original juiceman. In his book he states that fresh fruits and vegetables are full of digestive enzymes to break down food. He advises a mostly raw diet. He also states that whenever any cooked food it eaten, it should be accompanied by a freshly juiced vegetable juice and the juice should be drank within, like, 5 to 10 minutes after juicing it so you get the most enzymes. I know a lot is written on here about supplementing with enzymes (pills), but I think fresh is usually best. Not always convenient, I know, but it may be another solution. I recommend this book. I checked it out at the library for free.

          Also, has everyone given up coffee, yet, completely? I think that is the first step in this battle as coffee is super harsh on the stomach.

          • I am a sufferer of many digestive issues as well and I do have to 100 percent agree with cutting out coffee. I often say coffee is killing me and I don’t think I am too far off. I have stopped coffee a few days ago because I had to. I know it is tough, I quit smoking after 21 years much easier than the will to quit coffee, but it is a must!

            • I am drinking two small cups a morning right now and my stomach is starting to hurt me again. I am going to wean off by the end of next week. For me, it’s the habit and something I look forward to every morning. I have given it up for at least six months last year and I think my stomach problems (gnawing or burning all day) had gone away. That pain has been back for a bit once again so I’m ready to quit the coffee for good this time. I like this product called Dandy Blend. It’s an instant coffee blend sold on Amazon. It’s made out of dandelion root, chicory and beet root (and a few other natural ingredients) that you can use just like instant coffee. It’s a pretty good substitute. It’s just a little on the pricey side.

      • Hi I’m lynn. I have same issues for 40 years. They got better for a while now back again. Haven’t been able to figure it out. I hope you do. Feel better

        • No I have not been tested for gastroparesis. It does sound possible.
          I fired my GI Doctor after he performed an upper and lower GI. Everything was OK except for damage to the lower esophagus due to 12 years of heartburn.
          He asked me what’s going on Mr. Nixon . Then he told me I didn’t know what I was talking about and that he has a standard round of procedures that he performed on all his patients. Through these procedures we can make a diagnosis . And I thought why did you ask me what was going on.
          I haven’t felt this good on a regular basis for about 12 years . I have been supplementing with HCI with pepsin and with other digestive enzyme’s .
          If I feel heartburn coming on sometimes I will drink the apple cider vinegar mixed with water . This causes the LES to tighten thus relieving heartburn .
          The majority of my diet(70%) is fruits and vegetables . I limit carbs such as flour and grains. I don’t miss carbs as much as I thought I would because my health is much better . And I limit the portion size of proteins such as beef and chicken .
          I came across this information on low stomach acid while I was trying to rid myself of a bacterial infection . I got food poisoning at a restaurant .

        • I discovered the cause of my long term troubles were from low stomach acid .
          I made some dietary changes but nothing really helped until I started supplementing with HCI with pepsin.
          I came across this while I was trying to find a way to rid myself of a bacterial infection from food poisoning .
          I started dosing with olive oil and coconut oil for about a week and it seem to have gotten rid of the bacterial infection and my digestive system .

    • Look up mastic gum, manuka honey and expecially Hydrocloric Acid with pepsin, HCI…..Also activated charcoal to rid body of toxins…..Look up VSL 3, its a high probiotic for Ulcerative colitis and IBS…..take enzymes and apple cider vinegar before meals. Try acupunture…..GOD BLESS…

    • I think maybe you may have sibo or candida ask doctors to test you . I have a lot of those symptoms but with a lot of breathlessness and my stomach pushes up into my diaphragm it is very scary and I’ve been like this now fir 9 months and I’m suspecting sibo or candida and I did test positive for d. Fragilis a parasite . Good luck to you

  7. Hi have stomach problems for years. Nothing helps and it’s getting worse. Gas bloating nausea. Been gluten free for 2 months. Dropped 13 pounds but still have stomach issues. Am constipated most of the time. Am at wits end what to do. H pylori breath test negative. Waiting for biopsy from endoscopy 2 days ago. Have diverticulitis and colon polyps recently removed. Am on healthy diet. Take vitamin supplements. Don’t know what else to do. Rarely take antibiotics in years. Refuse to take meds like Prilosec as they don’t work. Was prescribed them took them for a couple weeks as no improvement stopped. Am on probiotic and eat yogurt everyday. Any suggestions would be greatly appreciated. THANKYOU

      • I agree that GERD is bacteria related and anyone with GERD should also investigate Low Stomach Acid.
        I started supplmenting with (HCl with pepsin) and (digestive enzymes).
        Looking back at my symptoms I now realize that my food would stay in my stomach for 2-4 hours. I would take Alka-Seltzer to flush my stomach contents into my small intestines.
        My stomach was not breaking down/digesting what I had eaten. Now that I am supplmenting with (HCl with pepsin) and (digestive enzymes) I know that my healyh has really turned around for the better.
        A few of my friends have finally gotten on board and are reporting good news.
        Essentially we are absorbing the nutrients we have consumed into our bloodstream. Thus our organs can do their functions, including the brain.
        My A1C was at 6.6 on my last doctor visit. The lowest number I had ever had was 8.2

  8. Thanks Chris for this article.
    I have symptoms such as heartburn, h-pylori and IBS when my carbs and sugar consumption is high.
    Is is possible to measure stomach acid by any tests?
    Thanks
    Andy

    • The Heidelberg Test at a doctor’s office that costs about $350. Otherwise an internet search on home testing can help.

  9. Chris,

    Thank you I had a very serious condition causing me to aspirate stomach acid, needless to say it was terrifying. Prilosec was prescribed, it sort of helped but after two courses it would always return. I began to critically think about the logic of reducing stomach acid and found this life changing article that you gracefully share with the world.

    I’m very happy to say that my health is returning albeit slowly esophagus and valves are healing and I have not aspirated for over a month now and my lungs and vocal larynx is healing as well. As you can see this affected my respiratory system which was the most concerning. Again thank you you are a true hero.

  10. Thank you for the article but I have a different view (while similar) over this phenomena. I had H . pylori which was removed. Once removed successfully, 2 months after that I developed strong symptoms of yeast overgrowth which I suspected was due to Antacids I had to take with Antibiotics which left my stomach defenseless. While I have been trying to get doctors to give me some anti-fungeral meds for the past 4 years with no luck, I have now once again developed GERD (I have managed this by avowing sugar and food that may contain fungi/yeast).

    I have now finally got Diflucan (one week) and slowly my GERD is improving. hoping that this will improve my stomach PH levels as well.

    What I am trying to say is that yeast has unfortunately being ignored and is possibly connected to this problem but have not been studied and not understood. Can you please let me know if you have come across this?

    Thank you

    • I had chronic heartburn for 10 years . The first four I treated with antacids. The next six years I treated with Alka-Seltzer 2 to 3 times a day. I slept in a recliner or elevated with pillows in my bed. I had immediate relief but the symptoms would be back in 6 to 8 hours.
      I switched to baking soda to remove the aspirin intake. I got the same relief as I did with Alka-Seltzer and saved money.
      When I considered a bacterial infection I decided to lay on the bed and roll around to fully coat the stomach. I noticed a prolonged time of symptom relief , 24 hours or more.
      This for me, confirmed it to be a bacterial infection.
      I was always leaving plenty of bacteria in the stomach to reproduce.
      I found thru reading that Olive oil and coconut oil was beneficial for their nutrient value and also found them to have antibacterial properties.

      My chronic heartburn is gone. I eat what I want. My health is returning , both physically and with increased mental clarity . I am not sure which one is the most beneficial because I started taking both at the same time . These were the only changes to diet or medication at the time I gained relief from chronic heartburn.
      They are inexpensive compared to doctors visits , filling prescriptions and lost wages due to illness.

      Do your own research on these two oils.
      No company in the pharmaceutical business wants to give citizens an inexpensive cure. They want to give you treatments so they can keep the door revolving .
      Remember they are in business of making money not in the business of charity .
      Most problems in this world can be traced back to a dollar.

      Good health to you !

      • Can you share how you used these oils? Nothing is working for me. Except when I get on an antibiotic for a few days for something unrelated.

      • Hello-

        My husband has successfully curbed his heartburn and GERD symptoms by following your e-book strategies. He is being scoped this week (colonoscopy and endoscopy). We are curious what, if anything, he should do to recover to maintain all of the success he has worked so hard at.

        his doctor is saying to take probiotics after the colonoscopy.

        thanks

  11. I appreciate the article and do believe that the bacteria is present with GERD; however, I am exploring the theory of bacteria being an effect of gastroparesis (slow digestion in the stomach). Because of the prolonged amount of time that the food is in the stomach, bacteria, naturally, can overgrow. I am currently studying the vagus nerve and how it can affect the stomach.
    See, I was a long-term, daily alcohol drinker (about 4-6 per day). I quit, cold turkey, about 7 months ago. I have had a whole slew of problems ever since, which no doctors or test have been able to solve. My most chronic and bothersome condition is my left upper abdomen pain. It is light pain, but usually constant. My left rib cage is a little larger than the right. I have most of the symptoms for GERD, although I think I have the lower esoph. version.
    The reason I have revisited the vagus nerve is that we all know that alcohol can cause nerve damage. For months now, I have had my left eye twitch and go a little blurry, my left throat kind of goes weak, sometimes pain in my left shoulder, and then down to my stomach. Common sense would indicate nerves here as well. I’ve had an EMG with all normal results.

    • Hi. You’d better consult your doctor for your abdominal pain and the other symptoms you mentioned. I really insist you do that, especially for your abdominal pain (although others are important, too). I do not want to frighten you. It’s just much better to do and may prevent further problems.

  12. I am not able to evaluate the science of this, but I have been puzzled by one symptom. I wake up at 2am every morning with acid coming up. I have to get up and take antacid. I have been asleep for 4-5 hours. I ate 7-8 hours prior to this. Why would there be “excess” acid under these conditions? It would seem that only a very small amount of acid is required.

    • GERD is not usually a symptom of having excess stomach acid, it is a symptom of having too little. The reason you get a burning sensation in your throat when you lay down is because the lower esophageal sphincter, or LES, is relaxing inappropriately and allowing stomach contents and acid to wash up into and burn the delicate tissues of the esophagus, it is commonly misconstrued as being caused by too much acid because of the painful effect even a very small amount of acid can have on the lining of the esophagus. A variety of factors can determine why the LES is relaxing inappropriately, nicotine usage, caffeine intake, diet composition, body weight and composition, chocolate consumption, genetics and a great many more factors can be at play.

    • Sometimes, if the abdomen is large, it can put pressure on the stomach and cause GERD, especially in the supine position (or laying flat.) Sleeping in an elevated position will have gravity help keep stomach acids where they belong. You can put blocks under your bed in the head portion, or use pillows. Another option is sleeping in a recliner. Best of luck.

      • Hi, I have read in somewhere, guess it was the Mayo Clinic site, that only putting pillows under your bed may put more pressure on the stomach. It’s better to use blocks under the head of the bed. I think the recliner may be the same as pillows.

    • Your body isn’t digesting the food quickly enough due to low stomach acid, therefore it can’t move to the intestines as quickly as it should.

      • I started using gastric acid with pepsin . I have also added digestive enzymes to aid in digestion . I suggest you go to John Baron.org and search for his article on enzymes for the modern diet because he explains the role of enzymes better than anyone I’ve found so far .

  13. IBS, GERD – daytime and nighttime/upon wakening, Functional Dyspepsia, Gastritis, and GB disease (not tested, but majority of symptoms there), and (possibly SIBO as well but not tested), 39 yr old woman with history of IBS once. GERD/Gastritis due to antibiotics for h-pylori. No h-pylori at this time – tested 2x. Want to know what to do? Tried all remedies and still re-starts upon immediate stress, spice, garlic, dark chocolate etc. for the absolute worse. Gets better with whole foods diet and juicing…but that does not allow me to have a normal social life eating 100% well and 5 small meals a day.

  14. Hi Chris,

    I have SIBO, and likely have H. pylori (still running tests). I am also fructmal and can only find relief on a low-FODMAP diet.

    I want to get rid of SIBO and the (likely) H. pylori, but I am reading that the typically recommended treatment protocols for each involve antibiotics that can eradicate strains that we rely upon in our guts. My gut is *already* pretty messed up, and I would like to avoid further messing it up. They DO say they would like to use pro-biotics to re-seed the gut, but pro-biotics are transitory….so unless they are talking abt giving me an FMT (which I do not believe they can promise that), I would be pretty devoid of strains I likely need to keep after one or both rounds of antibiotics.

    So….

    Is there by chance a “brown cross” that allows people to bank *their own* bacteria for later re-use in bringing it back into their own guts? I know they do this for cancer patients, but that is on a case-by-case basis, and used fairly quickly after chemo and radiation and so forth. My issue is SIBO and H. pylori — bacteria in the wrong places for SIBO and etc. I think I will wind up missing more strains if I “sanitize” my gut….and I don’t want that. I merely want the SIBO gone and the H. pylori gone.

    If there is a “brown cross” or any other banking of your own poo service, please let me know. I would really appreciate it.

  15. I find this article extremely irritating. There is evidence to suggest (http://www.nature.com/icb/journal/v86/n2/full/7100119a.html) that H. pylori is not an “infection” at all and that it actually plays a protective role against GERD. I’ve suffered from acid reflux for almost a decade, and my symptoms came on suddenly, most likely shortly after I had finished a course of antibiotics that finally did in my microbiome. I’ve tested negative for H. pylori, and I’m convinced that is precisely WHY I have GERD. In the non-industrialized world virtually everyone tested is “infected” with H. pylori, suggesting that it’s evolved with us over millennia. We’ve systematically wiped it out by dropping Napalm on our gut flora (antibiotics) and through our obsession with cleanliness. I want my H. pylori back! Feel free to pass it on!

  16. Hi

    I have read all the information on GERD and Heart burn and it all makes complete logical sense. I am however trying to confirm how a sliding hiatal hernia complicates the issue. Will following the steps still work all do you need surgery to correct the hernia?

  17. Hi Chris,
    I have GERD, IBS and Celiac Disease, have had 2 scopes (1st said I have a hiatus hernia, 18 months later the 2nd determined no hernia). I’ve just switched from taking Dexilant 60mg/daily to Tecta 40mg/daily.
    I’m having a lot of rebound (I think) reflux. I have been tested 3 times for H.Pylori with all tests being negative. I follow a low-ish carb diet. Is it possible that a different type of bacterial overgrowth could be worsening my symptoms?
    Thanks!

    • I had an H. Pylori stool test through my internist and 2 using endoscopy biopsies and all three came back negative. I did a stool test through DRG Labratory and it came back positive. There is no way to know for sure if it was present and undetected or if it was a new infection. If you have symptoms keep searching, try different tests. I only have reflux when I have a gut infection. Good luck!

  18. Hi Chris. I have had chronic acid reflux for a month now. It started at the same time as shingles. Shingles wore oFf within a week but the reflux continued. It is worse at night: I sleep for two hours at most. During the day, I feel a continuous stabbing pain in my chest. What is your take on my condition? I suspect shingles damaged my LES.

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