GERD Isn’t Always Too Much Acid. Here’s the Real Cause
If you’ve been diagnosed with GERD or acid reflux, you’ve likely been told one thing: “You have too much stomach acid.” This leads to the obvious solutions, acid blockers and long-term symptom management. In many cases, however, reflux is not caused by too much acid, it has more to do with how the acid is functioning in the body.
What Is GERD?
GERD (gastroesophageal reflux disease) occurs when stomach contents move upward into the esophagus causing; heartburn, burning in the chest or throat, regurgitation, and/or chronic cough or throat clearing.
The follow-up question to symptoms like this should not be ‘what is happening’, but ‘why is it happening’.
The Common Misconception
Most conventional approaches assume more acid equals more reflux, but many patient’s do not see improvement with acid blockers and sometimes even develop new digestive issues - suggesting something deeper may be going on.
GERD Root Causes (Often Missed)
Low Stomach Acid - This may seem counterintuitive, but it is actually pretty common. Stomach acid plays a key role in breaking down food and signaling to the lower esophageal sphincter (LES) to close. If stomach acid is too low, food will not digest properly, pressure can build in the stomach, and the LES may not close effectively - often leading too reflux symptoms.
Dysfunction of the Lower Esophageal Sphincter (LES) - The LES acts as a valve between the stomach and esophagus and if it weakens or relaxes inappropriately stomach contents can move upward. This dysfunction can be influenced by a number of things including diet, stress, and hormonal changes.
Increased Intra-Abdominal Pressure - Pressure in the abdomen can push contents upwards leading to common symptom pairing of reflux and bloating. This increased pressure is often correlated with SIBO or gas production and/or constipation.
Stress & the Nervous System - Stress impacts digestion by reducing stomach acid, altering motility, and affecting LES function. The gut-brain axis can play a major role win individuals with reflux symptoms.
Gut Imbalance - Microbiome imbalances (dysbiosis) can contribute to gas production, inflammation, and altered digestion which can all worsen reflux.
Why Symptoms May Not Improve on PPIs
Proton pump inhibitors (PPIs) reduce stomach acid, and while they may provide short-term relief, they don’t address the root cause (i.e. why the reflux is actually happening including digestive function/dysfunction and motility or pressure). In some cases, long-term use can further reduce stomach acid, impact nutrient absorption, and affect gut health - leading to symptom persistence even with treatment.
An Integrative Approach to Reflux
At Sun Valley Natural Medicine, we take a different approach. We look at the cause of reflux, not just the suppression of symptoms. Our approach may include:
Evaluating digestive function (acid, enzymes)
Assessing for gut imbalance or SIBO
Supporting motility and reducing pressure
Addressing stress and nervous system patterns
Personalized nutrition strategies
Our goal is not to just reduce symptoms, but to restore digestive function. Reflux isn’t always too much acid, it’s often a problem with how digestion is working.
If your reflux isn’t improving, or keeps coming back, it may be time to look beyond acid suppression.