What Everybody Ought to Know About Heartburn & Gerd | Chris Kresser
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What Everybody Ought to Know (But Doesn’t) about Heartburn & Gerd

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In the next few articles, I’ll be writing about the epidemic of gastroesophageal reflux disease (GERD) and its mismanagement by the medical establishment.

In this first article I will present evidence demonstrating that, contrary to popular belief, heartburn and GERD are caused by too little (not too much) stomach acid. In the second article I’ll explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. In the third article I’ll discuss the important roles stomach acid plays in maintaining health and preventing disease, and the danger long-term use of acid suppressing drugs presents. In the final article, I’ll present simple dietary and lifestyle changes that can eliminate heartburn and GERD once and for all.

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Heartburn and GERD Are No Joke

According to the National Institute of Diabetes and Kidney Digestive Diseases, sixty million people experience heartburn at least once a month and twenty five million experience symptoms daily.

Gastroesophageal Reflux Disease (GERD), a more serious form of acid reflux, is the most common digestive disorder in the United States. Studies show that 10-20% of individuals experience symptoms at least once a week, and prevalence of GERD is increasing steadily.

Drugs for acid reflux and GERD are cash cows for the pharmaceutical companies. More than 60 million prescriptions for GERD were filled in 2004. Americans spent $13 billion on acid stopping medications in 2006. Nexium, the most popular, brought in $5.1 billion alone – making it the second highest selling drug behind Lipitor.

As sobering as those statistics are, it’s likely that the prevalence of GERD is underestimated because of the availability of antacids over-the-counter. This permits patients to self-medicate without reporting their condition to a doctor.

Up until fairly recently heartburn wasn’t taken too seriously. It’s primarily been the butt of bad jokes about Grandma’s cooking. But we now know that heartburn and GERD can have serious and even life-threatening complications, including scarring, constriction, ulceration, and ultimately, cancer of the esophagus.

Recent studies also show that the damage from poor stomach function and GERD not only extends upward to the sensitive esophageal lining, but also downward through the digestive tract, contributing to Irritable Bowel Syndrome (IBS) and other gastrointestinal problems. IBS is now the second-leading cause of missed work, behind only the common cold.

Problems with the Conventional Theory

If you ask the average Joe on the street what causes heartburn, he’ll tell you “too much stomach acid.” That’s what most of the ads seem to suggest too. I’m sure you’ve seen pictures like the one at the top of this post in ads for acid suppressing drugs on TV and in magazines.

But there’s a big problem with this theory: the incidence of heartburn and GERD increases with age, while stomach acid levels generally decline with age (Fig 1).

Numerous studies have shown that stomach acid secretion declines with age. In one study researchers found that over 30 percent of men and women past the age of 60 suffer from atrophic gastritis, a condition marked by little to no acid secretion. Another study found that 40% of women over the age of 80 produce no stomach acid at all. 1

Figure 1. Mean stomach acid secretion from the second to the eighth decade. (from Wright, 2001 p.20)

graph of stomach acid secretion by age

Just as studies show acid secretion declines with age, it is also well established in the scientific literature that the risk of GERD increases with age.

If heartburn were caused by too much stomach acid, we’d have a bunch of teenagers popping Rolaids instead of elderly folks. But of course that’s the opposite of what we see.

In fact, according to Jonathan Wright, MD of the Tahoma Clinic in Washington state, when stomach acid is measured in people suffering from heartburn and GERD it is almost always low, not high. In his book Why Stomach Acid is Good For You, Wright explains:

When we carefully test people over age forty who’re having heartburn, indigestion and gas, over 90 percent of the time we find inadequate acid production by the stomach.

In Wright’s 25 years of conducting these tests, he found very few people with excess stomach acid. Excess stomach acid is only found in a few rare conditions like Zollinger-Ellison syndrome), and GERD is hardly ever associated with too much stomach acid.

What’s more, Wright and other clinicians have found that giving hydrochloric acid supplements to patients with heartburn and GERD often cures their problem:

In 24 years of nutritionally oriented practice, I’ve worked with thousands of individuals who’ve found the cause of their heartburn and indigestion to be low stomach acidity. In nearly all these folks, symptoms have been relieved and digestion improved when they’ve taken supplemental hydrochloric acid and pepsin capsules.

My own clinical experience confirms this. So far every patient I’ve had with heartburn or GERD has responded well to hydrochloric acid supplementation. We’d expect just the opposite to be true if these conditions were caused by too much stomach acid.

A Symptom Is Not a Cause

When I explain to patients that GERD is caused by not enough stomach acid, rather than too much, they are initially doubtful. “If that’s true”, they say, “then why do my antacid drugs provide relief?”

I’m not denying that the symptoms of heartburn and GERD are caused by stomach acid refluxing into the esophagus. Nor am I arguing that reducing or eliminating stomach acid with drugs doesn’t relieve those symptoms.

What’s crucial to understand is that any amount of acid in the esophagus is going to cause problems. That’s because its delicate lining isn’t protected against acid like the stomach lining is. You don’t have to have excess acid in your stomach to have heartburn.

Also, symptom relief doesn’t imply that the underlying cause of the problem is being addressed. Too often western medicine focuses on suppressing symptoms without paying attention to what is causing the symptom in the first place.

The misguidedness of this approach is clearly demonstrated by the use of acid inhibiting drugs to treat heartburn and GERD – problems which are caused by not enough stomach acid!

The Consequences of Ignoring the Cause

As I wrote above, Americans spend more than $13 billion on acid stopping drugs each year. This expense might be justified if antacid drugs were actually curing heartburn and GERD. But just the opposite is true. Not only do these drugs fail to treat GERD, they will make the underlying condition (not enough stomach acid) worse. This virtually necessitates the lifelong use of these medications for anyone who takes them.

While this is a nifty sales strategy for the drug companies, it’s a bitter pill to swallow (yes, pun intended) for those suffering from heartburn and GERD.

Curing a disease means eliminating its cause. When a disease is cured, the symptoms don’t return once the treatment is removed. This of course is not the case with drugs for heartburn and GERD. As soon as the patient stops taking them, the symptoms return. And often they’re worse than they were before the patient started the drug.

Unfortunately, pharmaceutical companies aren’t interested in cures because they aren’t profitable. It’s much more lucrative to sell drugs that people have to take for the rest of their lives than it is to promote dietary or lifestyle changes that would cure the problem.

Therefore, although the drug companies are well aware that GERD isn’t caused by too much stomach acid and that low stomach acid causes serious health problems and complications, they continue to sell billions of dollars worth of antacids to an unsuspecting public. Even worse, these powerful drugs are now available over-the-counter with no warnings about the dangers they present.

Note: if you think this sounds strangely like the situation with the #1 selling drug, Lipitor, you’re correct. Lipitor arbitrarily lowers cholesterol across the board, even though evidence clearly indicates that high LDL cholesterol is not the cause of heart disease. What’s more, low cholesterol is associated with greater risk of death in the elderly population. Something is definitely wrong with our “healthcare” system when the #1 and #2 medications are actually contributing to the conditions they’re supposed to treat. But I guess if you’re looking at it from the standpoint of the drug companies, who are in business to make a profit, it’s the perfect business model.

In the Part II I explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. We’ll also look at the primary causes of low stomach acid, and how you can prevent this condition from occurring. Read on!

  1. Sharp GS, Fister HW. The diagnosis and treatment of achlorhydria: ten-year study. J Amer Ger Soc 1967;15:786-791.

544 Comments

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  1. This makes complete sense to me for GERD! My problem is a little¬†more complicated¬†though, so I’m not sure what to do. Nearly 6 months ago I developed a bad case of gastritis after a stress-filled year and lots of spicy food and¬†a caffeine overdose. Normally, I take DGL and the gastritis heals in a month or 2. I didn’t have any on hand so, in desperation, I took Pepcid. Pepcid temporarily helped relieve the pain almost instantly, so I decided to stay on it, and then added DGL. When my other¬†gastritis symptoms (nausea, indigestion, bloating) continued for a few momths, I decide d to have an endoscopy with a biopsy. By that point, the pain had largely subsided. The endoscopy revealed mild gastritis. Both of my h. pylori tests were negative. However, after the stomach biopsy, I started having knawing, burning pain again but now a bit further down. I suspect that the biopsy was responsible for this and continued on Pepcid to reduce the irritation and promote healing. It’s been nearly 3 months since the endoscopy/biopsy and while the knawing/burning has gotten better, it’s still not completely gone. My doc said a PPI would work better but I was too afraid to take anything stronger than an H2 blocker. Aside from the slow healing, the most alarming thing to me is that since I started the Pepcid 6 months ago, I’ve developed chronic heartburn. I would always get some heartburn with gastritis, but¬†only when I ate high fat food and only during the acute inflammation. Now it seems like the gastritis is mostly gone but the heartburn is here every day. I suspect that Pepcid screwed up my whole stomach and I want to get off it, but I’m a bit afraid that I’ll be overproducing acid and that the gastritis will flare again. I’m not sure why else I get gastritis when I don’t take aspirin, NSAIDS, use alcohol, or have h. pylori. But now it seems I have GERD too, and I didn’t have this complication until using Pepcid. I’m going to try to wean myself off it slowly. My docs keep telling me to just take more and take it with antacids.

    • Hi Amy,

      You might want to work your way through this series and try some of the things I suggest in the last article on treatment.

      Good luck.

  2. I find this information absolutely incorrect. too much acid is the culprit. I’ve been taking Prilosec for 10+ years; my symptoms have resolved. The drug had absolutely saved my esophagus

    • You’re going to have to do better than that, Mookie. Of course Prilosec stopped acid from going into your esophagus. It almost completely halts stomach acid production. But that doesn’t mean acid reflux is caused by too much stomach acid. Did you actually read the article?

    • Guaranteed that you have low calcium, B-12, and Iron. The Prilosec may have saved your esophagus but it will destroy your health via osteoporosis and anemia if you don’t get off of it. There are ways to have all of it, go back and read the article for the sake of your health.

  3. I think the vast majority of physicians are good people trying their best to help others. ¬†Unfortunately, they are also victims of our broken health care system. They’re overworked, which leaves little time for them to read the relevant scientific literature. ¬†Instead, they get most of their information about drugs from the pharmaceutical companies themselves via sales brochures and sponsored conferences. ¬†I honestly don’t think most doctors are aware of the research I’ve presented in these articles. ¬†That said, I do wish more doctors would make it their business to be aware of the relevant research and not simply accept what they are told by drug companies. ¬†See my article When it Comes to Drug Claims, Skepticism Is Healthy for more on this.

  4. This may be a bit conspiracy theorist but…i wonder if primary care physicians (like say my GE Dr.who Rx’d me Prevacid for the rest of my life) get some kind of stipend (read kickback) from Pharms for doing so?

  5. For those who aren’t yet aware, I’ve published Part II and Part III of the series.

    Part II explores the hidden causes of heartburn and GERD.  Part III presents further evidence for the theories presented in Part II, and examines the connection between GERD and H. pylori (the bacterium that causes stomach and duodenal ulcers).

  6. Chris,

    Thanks for the reply about low-carb.¬† My experiment was several months on Atkins, so there was plenty of fat, but I grew incredibly stiff and fatigued till I could only hobble when I tried to run, and when I went back to my normal diet it took several months for the stiffness to wear off.¬† It was awful.¬† Regarding anti-nutrients, I have celiac disease and no matter how careful I am about gluten my acid problem doesn’t improve.¬† I eat almost no processed foods, of course, because of avoiding gluten.¬† So this is still all not quite adding up for me personally, but I’d like to get to the bottom of it so I’m looking forward to reading what else you have to say.

    • my spouse’s main symptom from gluten, from cross contamination or very small amounts, is heartburn. No gluten, no heartburn. Unfortunately, 20 ppm (which is what it takes to label a food as “gluten free” ) seems to be not gluten free enough for him. The Glutenzap forum has been very helpful in finding the very few processed foods he can eat without issue. No gluten, no heartburn!

  7. Jae,

    I wouldn’t give up on low-carb yet as a treatment for your G.I. issues. ¬†I’ve found that the majority of athletes don’t eat enough fat when they switch to low-carb. ¬†If you’re burning a lot of calories, you have to significantly boost your fat intake when you reduce carbs to provide adequate energy and avoid weight loss. ¬†Also, as Kim suggested, there is often a transition period that can be difficult when your body is learning to use fat as its primary energy source rather than carbs. ¬†L-carnatine can be helpful in this regard as it aids in fat metabolism and will help you get energy from the fat you eat.

    If you do continue to eat grains, it’s imperative that you prepare them properly (soak and/or sprout). ¬†This breaks down the anti-nutrients Kim mentioned and makes them more digestible. ¬†With your history of digestive problems, it may be worthwhile to get a gluten intolerance test from enterolab.com. ¬†Gluten intolerance is dramatically underdiagnosed and can cause serious G.I. issues.

    Kim, as I mentioned to Daniel, I’m aware that the prevailing theory of GERD is that it’s caused by a dysfunction of the LES. ¬†We’ll be looking at exactly what causes that dysfunction (hint: low stomach acid has a lot to do with it!) in the next article.

    You hit the nail on the head re: Big Pharma. ¬†The most profitable drugs for them are those that only address the symptoms, because that means patients will be dependent upon them for the rest of their lives. ¬†It’s even better when the drug actually guarantees the persistence of the symptom, as is the case with PPIs and GERD.

  8. To Jae:
    If your initial efforts to go LC were a problem, that may be an indication that you do need to give up sugars and grains. These are truly addictive! If you need more energy calories, use starchy veg as opposed to bread, pasta, cereal. etc. Even if whole grain, they are still highly processed, man-made foods. Also, nearly all grains contain anti-nutrients like gluten, phytates and lectins that cause all sorts of digestive issues among them, GERD, Leaky Gut, IBS, etc.¬† Once you detox from grains and sugar, I think you’ll feel better in the long run.

    To Daniel;
    I don’t think the author was trying to create a “strawman” by saying that too much acid causes GERD. On the other hand, can there by any doubt that the profits from these acid blockers drive Big Pharma sales? Let’s face it, like so-called “high cholesterol”, GERD was a medicalized disease that “needed” a pharmceutical solution.

    • I admit, I was addicted to sugar. You wont believe how much candy and junk i used to eat in a week! Why? Because I have a fast metabolism, I could eat whatever, not exercise, and not gain weight! Weird, I know. Then one day I caught a cold and developed a nasty cough with it. Well, my cold went away but the cough didnt. I thought it was asthma so id huff on my inhaler, but it didnt get rid of the cough. one day i woke up and all this acid is coming up my throat, i could taste it! Ive been plagued with this awfulness for a month now and already desperate to make it go. What do you think caused my gerd doc?

  9. The prevailing theory is NOT that typical GERD is caused by excessive stomach acid. Rather, the prevailing theory is that poor lower esophageal sphincter function allows those with normal stomach acid to experience GERD.¬† Since it is more difficult to control LES function (all known techniques involve tweaking neurotransmitters, as the LES is ennervated by the Vagus nerve, leading to significant side effects), controlling stomach acid, which brings symptom relief, is considered superior.¬† The reason young people don’t have more GERD is simply that they have superior LES tone. Older people, on the other hand, lose LES tone (for unknown reasons) and thus experience more GERD.
    There is room to debate the side effects of acid suppression, but your article doesn’t do that.¬† Instead, it seems you are arguing against a straw-man by claiming that doctors and Big Pharma think that hyperacidity causes GERD.

    • I’m aware of the prevailing theory and will address it I’m detail in the next article. Nevertheless, there is still a misconception amongst the public that GERD and heartburn are caused by excess stomach acid. That’s why I started the series with this article. Also, it’s important for people to understand that hypochlorydia is a primary contributing factor to GERD (again, more on this tomorrow). This is not the same as simply observing that GERD isn’t caused by excess acid. That would indeed be a straw man. Stay tuned for the next article.

  10. I never had GERD per se but had some really bad stomach problems I misinterpreted as food poisoning until they didn’t go away.¬† My chiropractor diagnosed low stomach acid and gave me HCl/Pepsin and poof! I was normal again.¬† But that was in 2000 and I still have to take it every time I eat.¬† I hope you’re going to address ways to restore the ability to produce stomach acid normally again.¬† I gather from the comments above that a low-carb or low-grain diet is recommended, but I’m an athletic person and my experiments with low-carb diets have been disastrous.¬† It’s very clear I need carbs to function, so I hope there’s some other solution.

    • Ya. Good thinking. The only thing I could recommend is cleaning out the colon/ digestive system. The best way I know to do this is Diatomaceous earth. It will help clean out the junk stuck to the intestine walls including parasites if they are there. Getting the digestive system all cleaned out could help things like acid production become normalized.

  11. My wife had “acid reflux”, and began taking HCL w/pepsin with her meals.¬† It helped a great deal in preventing the symptoms from occurring.¬† However, it wasn’t until we began eating a grain-free, low carb diet that the need for HCL went away.¬† Now she never has the reflux episodes.

    • Ya this is an interesting phenomenon. This must be a slight allergy to grain and seems to be very common.

      Personally I would eat grain when I wanted/needed to but making sure to take a HCL supplement.

      Have you tried digestive enzymes in addition to HCL before eating grains? It may be an insufficient amylase enzyme in the body that causes this possible allergy.

  12. I don’t see what causation declining stomach acid has with indigestion, reflux and GERD. Age does correlate with postural decay, and postural improvement causes a reversal of GERD. I suggest that the actual cause is mechanical- the pressure on the stomach being caused by slumping and excessive sitting. The acid is then pushed up into the esophagus. Simple, and hard to sell a drug for.

    • There are plenty of people without postural problems that have GERD, including infants. Infants do have hypochlorhydria, however. The connection between declining stomach acid and GERD is quite clear, as I’ll explain in my next articles. In short, low stomach acid encourages overgrowth of opportunistic bacteria, which in turn raises levels of gas in the stomach (hydrogen and methane primarily), which puts pressure on the LES and causes it to malfunction. Stomach acid is there for a reason. It inhibits bacterial growth, ensures proper assimilation of protein, carbs and fat, promotes vitamin and mineral absorption, and more.

    • Interesting thought, but wrong. How can you explain the cessation of GERD when people take acid supplements (HCL)?

  13. This series is very timely. I’ve been suffering from increasing problems with heartburn/GERD for 1.5 years – but I’ve already been mostly LC for 6 years and have recently been going more “clean”/paleo, so I’d be interested to see if your hypothesis covers my situation. About to undergo an upper endoscopy to see if there are any structural problems to be found. Would absolutely love to get off the meds and fix the root cause if I can. Richard Nikoley linked here with a¬†list of what he advises for getting PPI-free quickly. Staying away from the Scotch will be tough, but I’m willing to try if the evidence you present is convincing! ūüôā

    • Thanks for your comment, Eve. Stay tuned! The next article will be coming out soon.

      Unfortunately, you might have to ease off the scotch for a while. The reason alcohol can be a problem is the sugar content. I believe GERD is primarily caused by bacterial overgrowth. Bacteria thrive on simple carbohydrates. One of the most effective ways of treating GERD is a low-carb diet with very little sugar. Since most people with GERD have low stomach acid, replacing stomach acid with HDL & pepsin capsules is also helpful. More on this later.

      • Surprisingly, there are no carbs in scotch (or rum or other hard liquors) even though they are made from sugar.

  14. Great info. I, myself, was diagnosed many years ago with GERD. Two years ago I had an upper endoscopic procedure that confirmed the problem as well as a hiatal hernia (common) and some esophageal damage.¬† I had been taking loads of these acid blockers for all these years and frankly there were of minimal benefit. And to think of the literally thousands of dollars I’ ve spent on these expensive and dangerous drugs. Fortunately, I’ve been completely off them for a few months now.

    Although I’ve yet to take HCL (will check it out),¬† I decided last November to change to a low carb diet. I consume very little grain or sugar but lots of fat and protein. Guess what? After a month or so, I noticed that my symptoms began to disappear! I knew I was on to something. I started reducing my dosage of meds to half, then realized that I no longer needed them at all. When I have ocasional heartburn, I will take an Alka Seltzer for heartburn and that takes care of it.

    I can’t tell you the relief I feel physcially and emotionally. Last year I read that these¬†proton pump inhibitors¬†prevent the absorbtion of key nutrients and create deficiencies. One of the most troubling is calcium and the resulting higher fracture rate in older women.¬†They also prevent the absorbtion of many B vitamins including B-12 which I have been taking sublingually now for a couple of years. I rue the day the¬†ENT doc. told my my “cough” was a symptom of reflux and put me on prilosec.¬† I¬†found out a year and half ago that really I had asthma….runs in my family.¬†

    • Thanks for your comment, Kim. I’m glad you’ve found relief with a low-carb diet. Try the HCL w/pepsin – it should also help. Finally, there’s a strong connection between GERD and asthma that I will write about in a future article in this series. Both are connected to hypochlorhydria (low stomach acid).

      • Hi i have Gerd and i been taking HCL its working but i still have the burning throat sometimes do you take the HCL 648 mg everytime i eat a meal or once a day.

      • Help!

        I’m at wits end about husbands acid reflux. He had a knee relaced dur to a infections caused by malpractice in an injury. After the kneww surgury 3 yrs ago he develped acid relux. other wise he is in great healh though he smokes. I have gone the probiotic route and just started HCL PEpsin. the reflux has gotten somewhat better but is still a big problem. the pepsin makes him feel strange .IDK if it is worth staying on. today we finally visited the doc about the reflus. of course he is prescribing the usual. Protonics prilosec and zantac. he is 59. the reflux wears him out. i dont know what to do. can he still take the HCL pepsic while taking a proton pum inhibitor???

    • Just some good advice here from someone who is thinking long term in the GERD world: Do NOT get in to Alka-Seltzer for heartburn issues! Main ingredient (Aspirin) can tear away at your stomach wall and send you down the road to an ulcer.

      I only say this because you have options! Milk of Magnesia and calcium carbonates (tums. rolaids) are less invasive.

      • Alka Seltzer Gold has no aspirin.

        Active Ingredients: Each tablet contains:: Sodium Bicarbonate (Baking Soda) (958 mg (Heat Treated)), Citric Acid (832mg), Potassium Bicarbonate (312 mg)

        Inactive Ingredients: Magnesium Stearate, Mannitol

    • The gastroenterologist I was using and who did my first colonoscopy has blithely prescribed me Nexium and other PPIs, even suggesting using different ones over the course of a single day, and telling me “no problem taking them long-term.” It took me 3 months of tapering to get off the stuff, been using HCL and probiotics, sublingual B12. Vast improvement but I have noticed recently back to the constant throat clearing and swallowing after eating gluten foods. Think I am going to try the gluten-free for a week and see what happens.

      But I am never going back to that GI doctor. I think what she did borders on malpractice.

  15. Great post. I regularly get my clients to take the HCL test, originally promoted by Charles Poliquin, which will determine exactly how deficient in HCL they are. This helps GERD no end by allowing us to provide the optimum dose of HCL – it is there for a reason!

  16. These drugs are also very hard to get off. I was on them for a year
    and it took me 6 months to get weaned. I did very low carb paleo + ACV
    shots after every meal, but it was still pretty unpleasant. The
    impetus for me was that I acquired chronic salmonella, which isn’t
    exactly garden variety food poisoning for a 20 year old. I think the
    very low carb was important to starve hydrogen producing bacteria
    (Hyperlipid talks a bit about this
    http://high-fat-nutrition.blogspot.com/2008/08/helicobacter-and-hydrogen.html

    )

    I think it’s clear in my family at least, where most of us have GERD,
    that it’s probably not GERD, but another more recently elucidated
    illness called Eosinophilic Esophagitis, which is linked to an allergy
    to gluten. No gluten, no heartburn for us.

    But based on the most recent research, it seems like scientists are
    moving away from GERD= low acid to a model where all GERD is caused by
    immune system dysfunction. It will probably take a decade for most
    doctors to get the memo though…

    Perhaps allergens attack the acid producing cells or perhaps a high
    sugar diet unbalances your gut flora by allowing some hydrogen/methane
    producing bugs to go cray. The antibiotics they give you “just in
    case” of H. Pylori infection probably make things worse by altering
    the gut flora even more, probably allowing the inappropriate bacteria
    to proliferate further.

    • Hi Melissa,

      Thanks for your comment. As I’ll argue in the next article, I think the sequence probably goes something like this:

      Chronic stress / environmental toxins / poor diet / antibiotic use >>> hypochlorhydria / bacterial dysbiosis >>> increased gas / impaired nutrient absorption / autoimmunity >>> dysfuntion of LES >>> GERD

      So I agree with you that a high carb/sugar diet and bacterial overgrowth play a significant role, and both of these probably contribute to autoimmune processes that are also involved.

      Did you take HCL/pepsin and/or bitters when you were coming off the acid suppressing drugs?

      • I am so happy to have found your info. I have had scope testing to show I have a hiatel hernia and acid reflux. I also have been diagnosed with allergic asthma . I use inhalers as I wheeze constantly. I also take previcid for acid reflux. I constantly try to clear my throat and cough quite often throughout the day in order to clear. Otherwise I am fit lifting weighs , cardio, tennis and am a very active 59 year old except for this huge problem. I am thinking I need to have surgery to correct the hiatel hernia and an very worried about the acid and my esophagus . Any suggestions would be so helpful. Also when you say 30 grams of carbohydrates a day, what can one eat to not go over that small amount? Proteins I am great with. I love milk so can switch to raw milk or soy if needed.

      • In regards to your sequence breakdown, listed above, I’ve tried to apply that to my “acid reflux” struggle but am not seeing the parallel.
        1) I have no chronic stress, or spikes in my daily stress.
        2) I live and work in relatively clean environments, nothing with higher than normal toxins
        3) My diet is pretty clean and raw. Lots of produce. The only compromise is hot/spicy foods
        4) I take no antibiotics

        But yet I have to remain on the “omnipotent purple pill” otherwise I have intense heartburn and allergic response in my esophagus, to foods I have not formed a list for, that results in my throat/esophagus restricting the movement of food to my stomach. Inexplicably, I need to drink something to help the food pass. I am not sure what causes it, or why it happens. But I do know that it has something to do with my GERD and only happens when I stop taking Nexium. No other over-the-counter remedy is as effective.

        Any ideas and/or theories that may bring light to this antagonizing complication?

        • Hi,
          Sorry to hear of your need to be on the “purple pill.” Have you had any stool testing done by chance? I tested positive for parasites and overgrowth of Candida, even though I’ve not been on very many antibiotics. I was bitten by a tick and have Lyme Disease and we believe that either Lyme or Bartonella (another infection) is causing my stomach/reflux issues. Because of the Lyme then the opportunistic infections have taken over in my gut. Anyway, I mention this just to give you encouragement to try to get to the root of the problem. If you have ever been bitten by a tick it is a very real possibility that a tick borne infection could cause those very symptoms. Stool testing can reveal how your overall digestion is working; how your probiotic count is, how you’re digesting fats ect. Stool testing was very much worth having for me. I hope yo

        • Try eliminating dairy. I got instant relief. Then I eliminated gluten, and am symptom and med free unless I cheat. You will know within a few days if this is the path for you.

      • So glad to have just found this. I was sick for a couple of week with some sort of bacterial infection. My doctor finally prescribed an antibiotic and along with it a steroid because my seasonal asthma seemed to be kicking-up. When the temperature, chills, swollen glands and sore throat departed, a chronic wheezing cough remained with no phlem in the equation. Then I started to notice other symptoms linked to acid reflux. I just bought some over the counter antacid medicine last night and I’m definitely seeing a difference, but I was worried about it going away. I’ll try the hydrochloric acid next. Jeez, welcome to modern medicine! Get rid of one thing and get another thanks to the medicines.

        Here’s to hoping it works!

      • Hi. I didn’t experience indigestion until I started losing weight. I was doing weight watchers and eating great. I started getting severe indigestion twice a week. Then it got worse. I would take tums, rolaids etc. I didn’t think it was serious. I have got off my diet and started eating back to where I used to eat. Gained my weight back but the indigestion never left. I still get it twice a week. I only eat maybe twice a day and when I do its really not fatting. I love fruit like strawberries, apples. I can wake up in the morning take my kids to school and by the time I get to work my indigestion comes. I started using Zantacs. My mother saids I need to see a doctor because it always comes back and she fears heart problems. I seen where tums is antacids and the store clerk was telling me how it could be lack of acid. Which seems to be true because I lack fatty foods on my diet and now that im off my diet and rarely eat when I can it usually isn’t greasy foods but what I can get my hands on, meat, salads, or even a steak and cheese sub from time to time. What over the counter drugs can I take to build my acid? Which I strongly believe this is the cause. It has to be. It is the only thing in which makes sense. I mean, it didn’t start until my diet. Never experience indigestion in my life. Its getting worse after three years of experiencing it. I need help and I need to know what the best meds I can take.

        Thank you,

  17. Tracee,

    As I mentioned in the article, antacids will of course provide relief because they are suppressing stomach acid production.¬†¬† Some of the more powerful PPI drugs can reduce stomach acid to almost zero.¬† If there’s no stomach acid to get into the esophagus, then there will be no acid reflux.

    That all sounds great until you realize that stomach acid is there for a reason.¬† It is essential to nutrient absorption (protein, carbs, fat, minerals, vitamins) and protects us against infection, including h. plyori, which is the primary cause of gastric and duodenal ulcers.¬† What’s more, as I’ll explain in the next article, heartburn and GERD are actually caused by too little stomach acid.

    So while antacids may provide symptom relief, they are 1) ensuring that the underlying problem will worsen and continue, 2) raising the risk of serious nutrient deficiencies (B12, calcium, iron, amino acids, etc.) and 3) increasing the risk of autoimmune and other digestive conditions.  I will explain this in further detail in the articles to come.

  18. I know so many people with this, including my husband, and they do say the antacids give relief, so I’m never sure what to say to that. My son had horrific reflux as a baby, which can also be food allergies (which he did have). I wonder if he also has abnormal stomach acid.

    • First of all, I have been going through many websites for help and this is one of the best ones that I have found. Thank you for helping millions of people.I have something that might be able to relieve heartburn. FYI, I was in pain for about 2 months triggered by some steroids that did little to cure my rashes but instead brought along a friend name Mr.GERD.

      I have tried antacid.(Pills or Liquid all types)
      Verdict: Temporary Result. It relieves but that all it does at least for a while. Then it comes back in full force and I reckon if I am going to keep taking antacid is not going to solve anything.

      After trying various types of stuff, here is what I think is most effective for me in which you all can try. Here are the steps

      Step 1
      GERD is cause by reflux. To do that, you need to take anti-indigestion drug. Not antacid. They are different. I am outside now and can’t recall the brand but I will update soon on the name which I am taking.

      Step 2
      Then take papaya (cold ones).

      Step 3
      Then, you need to take Manuka Honey with UMF at least +15 (morning and before you sleep)

      When you sleep, don’t waste money buying those triangulated pillows for GERD. Just stack 2 pillows and tilt them slightly upright against the wall of your bed/ bed frame.

      All the best.

      • thanks for ur tips…it helps reducing my acid reflux..but can u give more tips for hiatal hernia?

      • Hi I have a question, I had bad allergies this year so I took a lot of apple cider vinegar straight shots for a month and now I’m experiencing gerd symptoms for over a month but you mentioned something about taking anti indigestive and the other day I had diarreah for a day and for some reason my symptoms reduced thanks to diarreah, is that why you mean taking anti indigestive instead? Thanks look foward for a reply

      • Yes, I was also prescribe by my doctor with anti indigestion drug to suppressed my GERD. I am using MOTILIUM (capsules or tablets) 3x a day before meals. I was also adviced to eat my meals in small pockets only. To lay down to sleep 3 hrs. after eating my meals Tomatoes, citrus fruits, mint and spicy foods and alcohol are a no-no.
        I also tried this, one tsp. of raw apple cider vinegar in one glass of water, before breakfast and before bedtime.
        For people with GERD, is a matter of managing the foods you take and changing your lifestyle.

        • That’s a good idea it’ll be hard but I think it well worth a try in not a big pill person so yes in starting this today

        • Have you Tried Betaine HCL With Meals + Probiotic Like Kefir. Sauerkraut And Reducing Grains ?

      • Calvin wrote:

        “Step 3
        Then, you need to take Manuka Honey with UMF at least +15 (morning and before you sleep)”

        What’s UMF and “+15”? I’ve had silent acid reflux for four months. I’ve tried the hydrochloric acid, have not tried with pepsin capsules. I’m 63, very healthy, never had this before. The hydrochloric acid eventually caused GERD. I’m also using the DGL Licorice. I do apple cider vinegar and sleep on a mound of pillows. I’ve always had a very healthy diet and take vitamins. I lean towards constipation and manage with magnesium with calcium. I’m tired of being sick. Got any recommendations? Thank you, Roxanne

      • I have been suffering with this GERD for so many years. Just got another endoscopy done, and in a lot of discomfort. Please help me to feel better.
        I am a elderly woman who has been suffering for a long time. Where and how can I get Hydrochloric Acid suppliments.
        My doctor never told me about it, and I don’t think he will give me a prescription for it either.

    • I was having bad GERD to the point of vomitting profusely … Started taking HCL and was cured within few days! Only had to take the HCL for a few days for problems to disappear for months…when any symptoms of GERD reappear I take. HCL for a couple more days and that gives my body enough acid to train itself to make more and I feel instant relief from my painful GERD symptoms.

      • What is the H?? Stuff where can I find it ? Is it prescribed or over the counter or around the house type of stuff or natural I’m lost but I may gerd as well. And how much is needed sry ur probably repeating urself with my common question asked already a thousand times sry just want to feel better on days I want to enjoy trying new dishes

    • I would like to join this discussion, I have tried much of theses methods with no noticeable results. But in fairness I may be looking for fast results & not giving treatment enough time. I believe I suffer from silent acid reflux. So when I saw my doctor I thought I had bronchitis or something. Symptoms matched asthma. They checked me set I was fine and thought it possibly maybe silent acid reflux. Went to my Gastric intestinal doctor and he scoped me. Said all looked good. My main symptoms are coughing chronically, Constant swallowing. And occasional lack of energy. I have never had heartburn. No burning anywhere. I think my diet is pretty good but you never know. What can I do?

      • I suffered with silent reflux for 2-3 years before I found Dr. Jamie Koufman’s book “Dropping Acid”. I followed the low acid diet and within 2 weeks I was cured. It was amazing! Try it and stop suffering. I know what you are going through. Don’t suffer any longer. I think you can get the book on Amazon.

      • I believe I have silent GERD as well. I don’t feel any actual burning or pain but have a chronic cough, like I am clearing my throat constantly.

    • My Granddaughter is 14 and has gerd very bad. She has had it for several years. Can this be caused if you are anxious and nervous? She is a special needs child.

      • From my experience GERD is mainly caused due to indigestion.. If your digestive system is not functioning properly then food cannot pass through properly and will cause acid reaction which will come back up.. You need to get your digestion back on track making sure that food is breaking down properly and exiting in a normal manner rather than coming back the other way..Nerves also seem to also play a part in this.. anything which causes your digestive system distress. Digestive Enzymes are a great start and they can help digestion.. Also just as Chris has said so many times, fermented foods.. good bacteria is essential… acidophilus can also help.. relaxation.. also not eating fast food, fried foods etc.. clean fresh organic food lots of salads, fresh fruits and vegetables..Herbs are good for flavouring food, Ginger and Tumeric are 2 very good spices also… Check your Vitamin levels also.. Don’t over eat or eat too late, and get some exercise every day to help food process through your system..

        • Hi, I can really relate to your desperation as I had a similar experience. I saw a few different gastro doctors and they all just offered PPI

          • GERD can come from low or high acid, stress, nonfunctional valve and symptoms like chest pressure and lack of air can be the nerves contracting and not allowing food to go down into the stomach.

            • Hi,

              I had a Barium Swallow and Eso Manomotry which shows is all in working order. Yes, I believe is from low acid. Actually, just saw a Functional Medicine specialist today and started a new diet- She ran some test plus blood work so hopefully in 2 weeks I will have some answers. These test and blood work are not available at a regular GI office. She did put me on a diet which include Bone Broth until the results come in. Told me not to touch grains so no bread or rice for me the next 2 weeks. Uffff… ūüėČ She also told me the antibiotic I’m taking for SIBO is not going to help me at all or the PPI’s.

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