What Everybody Ought To Know (But Doesn’t) About Heartburn & GERD

You are currently browsing comments. If you would like to return to the full story, you can read the full entry here: “What Everybody Ought To Know (But Doesn’t) About Heartburn & GERD”.

Related posts:

  1. The hidden causes of heartburn and GERD Research suggests that GERD is caused by maldigestion of carbohydrates and bacterial overgrowth in the...
  2. More evidence to support the theory that GERD is caused by bacterial overgrowth A recent study confirms the link between GERD & IBS and speculates that the two...

Tags: , , , , , , , ,

  1. Tracee’s avatar

    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.

  2. admin’s avatar


    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.

  3. Melissa’s avatar

    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


    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.

  4. admin’s avatar

    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 >>> hypochlorydia / 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?

  5. Marek London’s avatar

    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!

  6. Kim’s avatar

    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. 

  7. admin’s avatar

    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 hypochlorydia (low stomach acid).

  8. Eve M.’s avatar

    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! :)

  9. admin’s avatar

    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.

  10. Dan Schmidt’s avatar

    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.

  11. admin’s avatar

    There are plenty of people without postural problems that have GERD, including infants. Infants do have hypochlorydia, 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.

  12. Jim’s avatar

    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.

  13. Jae’s avatar

    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.

  14. Daniel’s avatar

    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.

  15. admin’s avatar

    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.

  16. Kim’s avatar

    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.

  17. admin’s avatar


    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.

  18. Jae’s avatar


    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.

  19. Chris Kresser’s avatar

    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).

Bad Behavior has blocked 509 access attempts in the last 7 days.

Better Tag Cloud