How to Eliminate GERD for Good in Three Steps (a Registered Dietitian’s Protocol)
If you want to know how to eliminate GERD for good, you’ve come to the right place! As a functional medicine-trained Registered Dietitian, I’ve perfected my protocol across hundreds of patients across the year.
Just as some background, a vast number of people experience heart burn, also known as acid reflux. Studies show that approximately 60 million US adults experience symptoms at least once per week (1, 2). The more severe form of reflux, known as Gastroesophageal Reflux Disease (GERD) effects 10-20% of the western population (3, 4). Despite how common reflux is, shockingly few people know the true cause of it! For this reason, reflux remains a chronic condition for most people. Fortunately, most cases of reflux have a treatable cause, which I will explain in this article.
But first, let’s clarify what causes reflux and GERD. Usually, the acidic contents of the stomach is kept out of the esophagus by the lower-esophageal sphincter (LES). However, when stomach acid escapes through the LES and enters the esophagus, symptoms of reflux occur. These symptoms include heartburn (a burning sensation in the chest or abdomen), bad breath, nausea, swallowing problems, respiratory complications, esophagitis, Barrett’s Esophagus, esophageal stricture, and vomiting (5).
There are basically two common non-surgical treatments for GERD. One is to lower stomach acid using either over the counter or prescription medications. These medications either neutralize acid (antacids), block its release (H2 blockers), or prevent its production (proton pump inhibitors/PPIs). The second common treatment is to recommend avoidance of “trigger foods”. These are foods that either are acidic themselves or are gastric irritants. Unfortunately, this traditional dietary advice has actually been disproved in the literature. Studies have shown that:
- There is no difference in reflux symptoms between low and high-fat meals, and there is no rationale for recommending a low-fat diet for reflux (6, 7, 8)
- There is no clear connection between alcohol and GERD (9)
- Coffee, beer, tea, and wine are not significantly associated with GERD, but white bread and sweets (carbohydrates) are – read on to discovery why (10)
High-fat diets, alcohol (beer and wine), coffee are not significantly associated with GERD – but specific types of carbohydrates are. I will explain why!
The surgical intervention for GERD (fundoplication surgery) is to tighten the LES by suturing the top of the stomach around it. According to the Journal of the American Medical Association (JAMA), this surgery is invasive and usually does not completely eliminate symptoms or the need for medication (11).
And that’s it. The problem here is that these approaches simply aim to reduce symptoms. They aren’t really an answer to the question of how to eliminate GERD for good. None of these approaches address the underlying cause. For example, according to a recent editorial from Gastroenterology, treating GERD by decreasing stomach acid will never be ideal because acid secretion is not the cause (12). Because of this disconnect, it is not uncommon for people to go years, or even decades, suffering through reflux symptoms, avoiding numerous foods and using acid-lowering medications. Not only does this approach fail to fix the problem, but there are significant risks of prolonged stomach acid suppression (which I will discuss below).
Wouldn’t it be better if you could eliminate the cause of GERD and reflux, then live without medication or surgical intervention? In this article I will explain what the underlying cause of GERD is for most people, outline the major risks of suppressing stomach acid, and suggest a 3-step process for addressing acid reflux.
What’s Really Going on with GERD
As for the cause of GERD, the question is why the LES is opening and allowing stomach acid to enter the esophagus. When the LES opens, this is called a transient lower esophageal sphincter relaxation (TLESR). Studies have analyzed TLESRs in GERD patients using manometry, a technique of lowering a pressure-sensitive tube through the LES into the stomach. These manometry studies have found that GERD patients experience lower LES pressure (weaker contraction), more belching, and more pressure in the stomach (intragastric pressure) (13, 14).
Obesity and pregnancy are independent risk factors for reflux, which means the condition is caused solely by the increased abdominal pressure in those cases (15, 16). However, the rest of reflux sufferers experience it for a different reason. A common belief is that they have high stomach acid. This is unlikely, as the risk of GERD increases with age, but production of stomach acid decreases with age. Studies have found that approximately 30% of adults over age 60 have atrophic gastritis (stomach inflammation associated with low acid) (17). Another study found that 39.8% of women over age 80 suffer from achlorhydria, or no stomach acid (18). Thus, it is not increased stomach acid, but the escape of stomach acid into the esophagus that causes symptoms.
So, the question is what causes decreased lower LES pressure, more belching, and increased intragastric pressure in GERD patients. One possible explanation for these findings is that something is causing increased gas in the gastrointestinal (GI) tract, forcing the LES to open more often or more forcefully. If this were true, then surgical tightening of the LES (fundoplication surgery) would lead to increased pressure in the GI tract. In fact, research has shown fundoplication surgery to do just that – it increases symptoms of gas, flatulence, and bloating (19, 20). In other words, the gas has to go somewhere. If it can’t go up, then it goes down (flatulence) and/or out (bloating).
So, where could this gas be coming from? Well, one answer is an overgrowth of bacteria in the small intestine, known as small intestinal bacterial overgrowth (SIBO) (21). Intestinal bacteria are usually only majorly present in the large intestine but, in the case of SIBO, bacteria have migrated to the small intestine and thrived there (52). These bacteria derive most of their energy from carbohydrates and produce large volumes of gas (22). The incidence of SIBO has been measured using the glucose breath test at 5.9% among younger adults and 15.6% among older adults. (52). However, the glucose test is known to be fairly insensitive for SIBO and, thus, the incidence is likely even higher. With 20% of adults experiencing reflux symptoms, it’s entirely possible for the majority of them to have SIBO. A second possible contributor to excess intragastric pressure is gut dysbiosis. In this case, there are too large a proportion of gas-producing strains of bacteria.
The Evidence that Gut Bacteria Causes Reflux
So, what is the evidence that gut bacteria cause reflux? If SIBO or gut dysbiosis were truly the cause of reflux, then you would expect lower carbohydrate intake to decrease symptoms. This is because gut bacteria depend on carbohydrate (especially non-digestible fibers) for fuel (23). Sure enough, research has found that low-carbohydrate diets significantly improve reflux symptoms (24, 25). This fact explains why research has found carbohydrate intake to be significantly associated with GERD symptoms (10).
And there’s more. The standard treatment for SIBO is antibiotics targeting the overgrown intestinal bacteria. Interestingly, research has shown that antibiotics reduce reflux symptoms and esophageal acid exposure, and increase LES pressure (strength of contraction) (26, 27, 28). So, eliminating bacteria with antibiotics actually improves acid reflux. If bacteria were not the cause of acid reflux, you would not expect any effect of antibiotics. This evidence further suggests that gut bacteria is a significant underlying cause of acid reflux.
In other evidence of this, studies have shown that feeding intestinal bacteria worsens acid reflux symptoms. Prebiotics are fibers that are not digested and absorbed by the human GI tract, but that are metabolized by intestinal bacteria. Prebiotics are helpful for gut health if bacteria are in the correct location, but they worsen SIBO symptoms by feeding the small intestinal growth. A study looking at the prebiotic fiber fructooligosaccharide (FOS) found that GERD patients treated with FOS experienced an increased rate of TLESRs, a higher number of reflux episodes, and worsened GERD symptoms (29).
As final evidence of the SIBO – reflux connection, you would expect an increased rate of reflux in populations known to experience high rates of SIBO. In fact, this is the case. Cystic fibrosis patients have an increased rate both SIBO and reflux (30, 31, 32, 33). The reason for this is believed to be that they have a mucus blockage of the pancreatic duct. This duct usually releases the carbohydrate-digesting enzyme amylase. When carbohydrates can not be digested, they move further down the GI tract and reach bacteria which grow and thrive on it.
In another example, Irritable Bowel Syndrome (IBS) patients experience significantly higher rates of both SIBO and GERD (34 35, 36,37). Just like with acid reflux, treatment of IBS with low-carbohydrate diets and antibiotics is often successful (38, 39, 40, 41). This evidence shows again that reflux has a strong connection with gut bacteria.
I hope you now see the strong evidence that a common cause of acid reflux is SIBO. The natural question to then ask is what the cause of SIBO is. One cause can be low stomach acid. Yes, you read that right! Reflux sufferers are usually under the impression that their stomach acid is too high when, in fact, the opposite may be true. Low stomach acid can be caused by H. Pylori infection (a bacterial infection of the stomach), use of acid-lowering medications, or chronic stomach inflammation (chronic atrophic gastritis, CAG) (42, 43). The cause of CAG can be either a response to H.Pylori and/or acid-lowering medications, or it can be caused by an autoimmune attack of the parietal (acid-producing) cells of the stomach. Regardless of the cause, low stomach acid has been linked to increase risk of SIBO. Therefore, one important step for acid reflux sufferers is to determine if they have low stomach acid and, if so, to address it.
There are several other conditions associated with SIBO that should also be considered. These include:
- Impaired gastric motility
- Lack of pancreatic digestive enzymes (amylase to break down carbohydrate for digestion)
- Celiac Disease
- Irritable Bowel Syndrome (IBS)
- Irritable Bowel Disease (IBD) – Crohn’s and Ulcerative Colitis.
Therefore, the major question with acid reflux is whether SIBO and/or gut dysbiosis are present. In the case of SIBO, low stomach acid should be investigated as a possible underlying cause. If stomach acid is normal, then other possible causes should be investigated.
The major question with acid reflux is whether SIBO and/or gut dysbiosis are present.
The vicious cycle of GERD
Whether or not acid reflux starts with SIBO, the unfortunate truth is that standard reflux treatments can increase SIBO risk. As discussed previously, reflux and GERD are often treated with stomach acid-lowering medications. Of these, proton pump inhibitors (PPIs) have the strongest acid-lowering effect. Remember that low stomach acid is linked to increased risk of SIBO. There is a strong body of evidence connecting stomach acid-lowering PPIs with SIBO:
- A 2013 meta analysis scrutinized all literature on the connection between PPI use and SIBO. It found that there IS a significant connection between PPI use and SIBO, but only when the gold standard SIBO tests are used (duodenal or jujenal aspirate cultures) (44).
- A clinical trail found that when Prilosec (a PPI) was given to 30 GERD patients for three months, 11 of them developed SIBO, while only 1 out of 10 controls developed it (45).
- In another clinical trail, when GERD patients were treated with a PPI for 6 months, 26% developed SIBO and a statistically significant number of them developed IBS (51).
Thus, a vicious cycle exists here. Gut dysbiosis and SIBO can lead to GERD, and treatment of GERD by lowering stomach acid can lead to SIBO. This cycle is part of the reason why patients often remain on these medications indefinitely. The problem with this, aside from ongoing suffering from GERD, is that low stomach acid poses other significant health risks. These include:
- Decreased nutrient absorption (iron, B-12, zinc, folate, and calcium) (46)
- Impaired digestion (47)
- Decreased resistance to infection (i.e. pneumonia) (48 49)
- Increased risk of gastric cancer (50)
Thus, ongoing stomach acid suppression is by no means harmless. Fortunately, there is a way to break the vicious cycle, wean off acid-lowering medication, re-build gut health.
3 Steps to Eliminate GERD for Good!
As outlined above, traditional surgical and pharmacological approaches to GERD are ineffective and even harmful. Fortunately, there are safe, effective ways to reduce or even eliminate reflux symptoms for most people. These methods do not address the independent risk factors of obesity and pregnancy, but are otherwise effective. The three steps are:
1. Get Tested – Work with a medical provider to test for low stomach acid, nutrient deficiencies, SIBO, and gut dysbiosis. You may be able to accomplish these tests with either a gastroenterologist or a functional medicine doctor.
2. Eliminate the cause of your symptoms using a functional approach – Aim to eliminate SIBO if present, normalize stomach acid, and wean off acid-lowering medication. In addition to your physician,find a functional nutritionist who can help you through this process in a variety of ways:
- Use natural anti-microbial interventions to eliminate SIBO bacteria (note: alternatively, your physician may prescribe antibiotics that specifically target SIBO bacteria)
- Guide you through the various dietary interventions used to treat SIBO (low-carbohydrate, low-FODMAP, Specific Carbohydrate Diet, GAPS diet, or elemental formula)
- Recommend digestive enzymes to improve break-down and absorption of protein and nutrients, which is compromised when stomach acid is low
- Provide options for natural remedies to increase stomach acid
3. Restore healthy gut function – prevent re-occurrence by improving digestion and absorption and by restoring beneficial bacteria. Your functional nutritionist can work with you to find the best functional foods, prebiotics, probiotics, and remedies to restore healthy gut bacteria and mucosal lining. Enjoy your reflux-free life!
Conclusion
Many GERD sufferers are under the impression that medication, food avoidance, and possibly even surgery are their only treatment options. Unfortunately, these treatments fail to address the underlying reason for increased gastric pressure and leaking of stomach contents into the esophagus. Lowering of stomach acid is also not benign – it increases risk of nutrient deficiencies, infection, poor digestion, and gastric cancer. Lowering stomach acid can also worsen SIBO and gut dysbiosis, creating a vicious cycle that makes weaning from medication impossible.
Fortunately, there are ways to get tested, address SIBO and gut dysbiosis, and to restore gut health. These are the true steps for how to eliminate GERD and reflux. Working with a team of professionals to accomplish this is the best approach. I hope this article has given hope and ‘food for thought’ if you suffer from GERD. You don’t have to live with symptoms and medication forever. Please feel free to contact me with questions, or share them below in the comments!
Bonus!
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Best wishes,
Erin Skinner, MS, RD, IFNCP
Integrative and Functional Registered Dietitian Nutritionist
P.S. Please don’t forget to reach out HERE to request a free chat to discuss how I can help with your digestive healing journey.
Always glad to see a root cause approach. You can nurse the victim back to health, but if you don’t handle the culprit, the victim will keep getting hurt! — The Scientist @ TheElegantScience.com
Hi Erin, thank you for the well written article! The information is laid out very clearly and easy to understand. I hope you can answer a question for me, as I seem to be getting to my solution here, but I’m hitting some road blocks. Thankfully this lead me to your website.
I have been suffering acid reflux for years now. I’m 27 and very healthy on the outside, i’m an athlete and what is commonly thought of as a healthy American diet. My acid reflux was always "manageable" by the usual, lay off the coffee/ chocolate/ alcohol, and I would only take about 3-4 Tums a week. After a trip to central america, I got food poisoning, thought it was a parasite, had every test done, and they ultimately told me I was probably imagining things.
A year down the road, thousand of dollars in doctors bills poorer, and countless bottles of Tums later, I have taken matters into my own hands. For the last three weeks, I have taken on a plant based, no complex/ refined carb diet (couldn’t cut alcohol yet though) and WOW. The results were astonishing. I not only felt cleaner, lighter, and overall better, but I haven’t had anything close to a sign of reflux in that entire time. Even when drinking alchohol/ coffee, still nothing. So naturally I am very happy. But, there’s still some problems here.
My stools are still oily and sometimes I am constipated, with white specs in the stool with a yellowish/ greenish color. This has happened for the past year, but it’s happening less now with the new diet. In fact, my stools are passing way more frequently and look "healthy" about 50% of the time. But I am still getting some of the aforementioned discolored stools with white stuff in it. I have read this may be due to the gall bladder or liver (can’t remember) not processing fats correctly. Whatever the reason is isn’t the issue (but nice to know), I just want to take the final step here to cure me, as I still feel something is awry in my body. I am going to try the diet you mentioned and do a cleanse first. Then do the FODMAPS diet and then the GAPS diet. I am hoping this works for me!
The silver lining here is that the increased energy/ good feelings I have gotten just from cutting the complex/ refined carbs has been immense. I don’t think i’d ever have done that if it weren’t for the necessity. Now I don’t see myself ever eating them again, at least not in any volume like I used to. Also, I have learned a great deal about cooking simply and quickly and it’s way cheaper than eating out all the time like I used to. Thanks again Erin, love your website!
Hello Tim, thanks for sharing your story and congratulations on having some improvement with your reflux! I’d be happy to discuss your plan in more detail if you like. If you’d like to shoot me an email, please do: Erin@RealNutritionRX.com
Best wishes and Happy New Year!
What kind of carbs DO you eat? When you say no complex carbs im thinking potatoes. When you say no refined carbs Im thinking anything made from flour (bread, pasta, etc). Do you just eat rice? I ask this because all my reflux/gerd post nasal drip whatever you anna call it all started after a severe 3 week illness in November 2013 and I have never recovered.
Hi Matt, thanks for your question. It sounds like you probably have post-infectious IBS, which is the most common cause of IBS. Technically, it should be low FODMAP carbs. There’s a free meal plan for low FODMAP higher on this page and I give an overview of the diet during this seminar: https://recoveryfromibs.clickfunnels.com/4-tummy-trouble-tricks-webinar-registration Unfortunately, it’s not a simple answer as far as what carbs are low/high FODMAP. I recommend watching the seminar to get a good overview with some resources for further learning around it.
Thank you for the follow up information. I will take a look. I’ll also look up post-infectious IBS, that’s a term I have not yet encountered.
Hello Sir,
gone through your informative article i am just 25 yrs (M) suffering from gas acidity sometimes respiratory problems (asthama and cough).
I did endoscopy and h pylori came positive.
I am not able to get whether h pylori is the culprit or the small intestine bacteria overgrowth.
will antibiotics work or h pylori specific please guide so that i can communicate to my doctor about it.
Hello Gaurav, thanks for your comment and I’m so sorry for the delay – I somehow didn’t get a notification for this one. If you’re still struggling with your symptoms, please feel free to send me an email – erin@realnutritionrx.com .
Great information! At the advice of my naturopath I am on a low FODMAP diet. It’s been about 4-5 days now, and the last two days I noticed significant improvement. Unfortunately today my symptoms are back. Is it normal that if my symptoms are related to SIBO, that my improvements would fluctuate? I’m hoping it is just a temporary set-back.
Hello John, thanks for your comment. Yes, that could be due to a couple of things – either a flare of your SIBO or accidentally eating more FODMAPs than intended (its hard to get it perfectly at first). If you want to discuss further, please feel free to shoot me an email – erin@realnutritionrx.com . Good luck to you!
Hi, i had a H Pylori infection due to low stomach acid and the antibiotics i took caused SIBO and severe acid reflux, its been 6 months and i can’t get rid of it. I’m on the Gaps diet but it doesn’t seem to be helping, I’m losing hope….what else can i do to increase stomach acid?
Hi Marilene, thanks for the question. For SIBO, it takes more than GAPS to get rid of it. You can take betaine HCl for low stomach acid, plus you’ll need SIBO treatment. That can be herbal antimicrobials, prescription antibiotics, or an elemental diet. I hope that helps! – Erin
Please help. 17 year old daughter. Acid reflux 3 years.much worse since December. On nexium 40 mg. Just been advised low fodmap. Already diagnosed coeliac 8 years ago. Strictly adheres to gf diet. Has lactose free milk. No carbs apart from veg.
Symptoms inc belching. Swollen tender epigastric area. Pressure feeling. Heartburn.reflux. Bloating. Always has cough
Hi Jayne, sure, please shoot me an email and we can set up a call. Erin@realnutritionrx.com . – Erin
is this written by Norm Robillard?Seems like the same thing
Hi Erin
Loved your article, so well written.
I am a 54 year old female who has only recently stopped taking Nexium after nearly eight years.
Been on FODMAP diet for about five years.
In a nutshell I have still pretty much suffered reflux all that time and food felt like "the enemy" 🙁
A month ago I got sick (chesty productive cough) and was put on antibiotics (Clarythromicin) which to my TOTAL AMAZEMENT appears to have solved my reflux issues 😀
Would love to hear your thoughts and recommendations.
Thank you so much for your extremely enlightening article.
Regards
Nerida
HI Nerida, thanks for your comment. It sounds like small-intestinal bacterial overgrowth is likely the root cause of your reflux. I’d be happy to discuss it further if you like. You can get my contact details from the ‘contact’ tab at the top of this page. Talk soon! – Erin
How to you increase stomach acid?
Hi Carla, thanks for your question. I use supplemental acid at first and there are a variety of forms from apple cider vinegar to betaine HCl. Then, for the long term, I work on improving acid production. – Erin
Hi Erin
Thank you for your article. I have had acid reflux sudden onset 8 months ago, I refused ppi treatment as I was breastfeeding and also not willing to accept that acid reflux was this disease that came from nowhere. I have undertaken a sibo test last week and am awaiting the results. Your article gives me hope that if I have sibo, i can cure that and acid reflux.
Doctors here in the uk have barely heard of sibo.
Regards Hayley
Hi Hayley, thanks for your comment! I’m so glad that you were able to get a breath test. What did your results show? Good on you for resisting PPIs and for breastfeeding. 🙂 – Erin
Hi
I had a rupture in my small intestine and have since had a multiple of health issues: IBS, Hernia, acid reflux and I have been told I also have some Bacterial overgrowth in my digestive tract🤦🏻♀️
I suffer from bloating/ cramps and a general unwell feeling on most days. Would you kindly recommend what I should take to help live a healthy life.
I am on omeprozole reduced to a few days a week. As I have also been told of weak / thinning density in my bones through a Dexa scan
I would really appreciate a product list you feel would benefit someone like me.
Warmest Regards
Hi Royella, thanks for sharing some of your story with me! Yes, let’s discuss it! Could you please send me an email? It’s Erin@RealNutritionRX.com . Talk soon. 🙂 – Erin
Thanks for the informative article, Erin. Your explanation of the Sibo/Gerd connection is similar to that of N. Robillards ( Fast Tract Digestion), which I also found very helpful. I was diagnosed with Sibo and Grade C esophagitis this past year. I am on the second round of antibiotics and will have my stomach ph tested (finally) next month. The inflammation has also affected my singing voice, so I’m hoping the second endoscopy will show that I am healing. I pretty much follow the diet suggested in Fast Tract and take a small amount of enzymes with main meals. If you have any other suggestions for healing tissues surrounding the larynx, please share. My symptoms started in the stomach region, but I feel fairly certain that all my symptoms are related.
With warmest regards.
Hi Suzanna, thanks for your comment! I’m sorry to hear that you’re struggling with this, and that it’s having an effect on your singing voice. I’d love for you to keep me updated on how your’e doing. If you want to meet and go over your diet, supplements, etc, let me know (erin@realnutritionrx.com ) . For sure I would say to take either bone broth or collagen protein (high quality) to help your tissue heal. Good luck! – Erin
Very helpful info. Can Sibo give pan chronic gastitis? Cyrex labs sibo/ibs blood test said i had 2 markers that reveal a low positive for gram neg. Bacteria in the small intestine. I was also told i have ibs from my colonoscopy 4 yrs ago. When symotoms started. Actually my first symptom was Refux. I didn’t know what was wrong with me. I was gasping and couldn’t lie down comfortbly. I went to ent and was scoped. Dr. Said my throat looked like a smokers throat and i never smoked. I was put on Antibiotics because drs didn’t know what was wrong with me. I was told i had bad reflux from ent though. After i was almost done taking zpack i started feeling much better. I felt great for around 4 weeks. Then the symptoms startred to return. So clearly there was a positive reaction to the antibiotics. It must be bacterial. Ive seen several GI drs. And 3 endoscopies. They refuse to diagnose me with sibo. My breath test also looked low positive.
My baseline was 14 and i believe after 60 min. I was at 24. They said it was Negative. I always feel terrible. Chronic bloating now and pain. Ive lost a lot of wieght mostly muscle mass. I have reflux. Lack of energy. Blood wrk shows normal b12. Any help would be Greatly appreciated! Thank You
Hi Karen, thanks for your comment. You sound like a perfect candidate for SIBO testing and treatment. I lead the group of SIBO-treating Dietitians and have many years of experience. However, there are also other practitioners who are skilled at SIBO treatment. It’s unfortunate that this treatment isn’t usually available from your conventional/insured healthcare provider. Please feel free to get in touch if you’d like to discuss it: info@realnutritionrx.com . Best wishes to you! – Erin
Hi my name is jeanne, I have acid reflux all day.I have been on a keto diet for six week and lost 15lb. This acid reflex in getting old.I have been doing apple cider tablets and that only helps for a little while.Iam eating a great diet . My health insurance in not great. I there any natural remedy I can try ?
Hi Jeanne, yes, I use herbal antimicrobials all the time and they are incredibly effective. In studies, they are shown to be equally effective to prescription SIBO treatments, but they do take longer (~4 weeks vs 2 weeks). Feel free to get in touch if you want to discuss it: info@realnutritionrx.com (or contact tab above). – Erin
Hi Erin,
I cannot believe I found this article just after I was prescribed an antibiotic for a UTI and found my GERDS symptoms greatly improved! I feel like I was a one person experiment! My physician kept offering me acid reducing medications for the GERDS. I tried one and all it did was give me increased gas and abdominal discomfort. So I have been living with GERDS for years being very careful what I ate and very little acidic foods. Then I had pain in my kidney areas and was diagnosed with a UTI and put on an antibiotic. I felt like 80% better the next morning already and thought the GERDS felt a bit better and just brushed it off as a slight pain relief euphoria! The next morning I felt improvement as well and had less heartburn when I did my morning chores (I live on a small farm and had adapted to doing some of the physical and bending tasks on an empty stomach to avoid pain). That’s when I decided to research it and came across your article! Thank you! Your research gives understanding to what I am experiencing and gives me hope! I would be thrilled to gain more information on improving my health regarding this!
Hi Kathleen, thanks for your message and congrats on your discovery! It sounds like you’re on the right track with figuring out the root cause of your GERD, so that you can address it for good. If you need help with SIBO testing and treatment, feel free to get in touch ( info@realnutritionrx.com or contact tab above). Best wishes to you! – Erin
Hi Erin I am very grateful for your great article. I would like to ask you what kind of diet would you recommend for me to deal with my problem. I also would like to ask you is it correct that consuming ACV will make Gerd worse and will damage my delicate esophagus because of its acidic nature . i would like to also ask you do you agree with those who say you should adopt a low acid diet to deal with Gerd which would also mean not consuming ACV.