Acid Reflux


GERD (gastroesophageal reflux disease), a.k.a. acid reflux, is a very common health condition in the modern lifestyle. Acid reflux is often thought as a condition of overproduction of stomach acid. However, there’s actually another group of people whose acid reflux is caused by low stomach acid.

Common causes of GERD:

  • Stress, hypercortisolism (over active adrenal glands) – cause over production of gastric acid

  • Low gastric acid (hypochlorhydria) – the lower esophageal sphincter (LES), is a muscle connecting esophagus and stomach, which controls the passage of food and prevents stomach content from refluxing back into the esophagus. The LES stays closed when there’s sufficient gastric acid. When there’s not enough gastric acid (in case of low digestive function or use of antacids), the LES cannot close properly and causes reflux.

  • Hiatal hernia

  • Obesity

  • Pregnancy

Health risks associated with GERD

Chronic acid reflux can cause pathological changes of the esophageal mucosal tissues, resulting in Barrett’s esophagus, which is a precancerous change of the tissue and it increases the risk of esophageal cancer.

GERD caused by over production of gastric acid

Associated symptoms

  • Gastrointestinal

  • Often accompanied by over production of pancreatic enzymes and bile

  • Bad breath, bitter taste in the mouth, oral ulcer, bleeding of the gum

  • Excessive thirst

  • Excessive hunger

  • Chest pain or burning sensation

  • Constipation

  • Gastric ulcer, duodenal ulcer

  • Cardiovascular

  • Palpitations

  • Dry cough

  • Elevated blood pressure

  • Emotional

  • Irritable, angry

  • Other

  • Insomnia

  • Ringing in the ears

  • Headache, dizziness


  • Find out and address the root cause, instead of suppression

  • Reduce stress, reduce cortisol production

  • Avoid foods that trigger gastric acid production (spicy foods, fried foods, coffee, sugar, refined carbohydrates, etc)

  • Avoid over consumption of foods and drinks

  • Protect the esophageal and stomach lining

Refer to the post about adrenal fatigue to know more about how adrenal dysfunction can cause acid reflux.

GERD caused by low gastric acid

  • Commonly seen in elderly people (due to low digestive function from degeneration of body function)

  • Often causes malnutrition, anemia, and osteoporosis

Associated symptoms

  • Gastrointestinal

  • Gas and bloating

  • Diarrhea and/or constipation

  • Gastric ulcer

  • Poor appetite

  • Food allergy/ sensitivity

  • Tends to have low blood sugar (hypoglycemia) easily

  • Gallstones

  • Other

  • Low immune function, gets cold easily

  • Phlegm

Some root causes of low gastric acid

  • Usually due to: H. pylori infection, hypothyroidism, low digestive function from age, etc

  • H. pylori – eliminate the bacteria.

  • Hypothyroidism – figure the root cause of hypothyroidism, support thyroid function.

  • Low digestive function – supplement with HCL, pancreatic enzyme, and bile. Improve digestive function with herbs.

Side effects and complications of antacids

Antacids’ (H2 receptor antagonist or proton pump inhibitor) main function is to inhibit gastric acid production. However, as we mentioned above, low gastric acid can actually be a cause of acid reflux and it can cause health conditions like anaemia and osteoporosis.

Functions of gastric acid: antibacterial, breakdown food particles and facilitate absorption of nutrients like protein, calcium, iron, zinc, vitamin B12 and folate.

Therefore, when there’s insufficient gastric acid, it can cause:

  • Dysbiosis – imbalance of bacteria flora in the intestines, overgrowth of pathogenic bacteria

  • Amino acid deficiency – affects muscle formation and neurotransmitter synthesis, impairs immune function.

  • Calcium deficiency – can cause osteoporosis

  • Iron deficiency – can cause anemia, affects neurotransmitter synthesis and balance

  • Zinc deficiency – affects immune function, skin health, synthesis of testosterone

  • Vitamin B12 and folate deficiency – can cause anemia, increases cardiovascular disease risks, affects neurotransmitter synthesis and balance

Antacids can effectively relieve the symptoms of acid reflux, however, on the long run, it can cause many health problems. Besides antacids, many pharmaceutical drugs like anxiety, depression, high blood pressure and high cholesterol medications can cause nutrient deficiency. For more information please refer to the post “Drug induced nutrient deficiency – the importance of checking nutritional status while on pharmaceuticals.

Diet and Lifestyle recommendations for GERD:

Avoid following foods:

  • Sugary food and drinks (sweets, fruit juice)

  • Refined carbohydrates (white bread, cookies, cakes)

  • Coffee, alcohol

  • Spicy foods, fried foods

  • Peppermint (in the form of herb or essential oil) – relaxes LES, can potentiate acid reflux

Do the following:

  • Avoid overeating and over drinking

  • Chew foods properly and eat slowly

  • Avoid eating 2 hours before bed

  • Avoid eating 1 hour before exercising

The fundamental solution to acid reflux is to find out the root cause and supplement with either herbs, amino acids, vitamins or minerals to 1. regulate digestive function, 2. protect the esophageal and stomach lining, 3. replenish nutrients that are deficient.