25/07/2025
Rethinking GERD: Beyond Acid Suppression
Common practice: Antacids are prescribed widely—often as “some candy”—to provide rapid symptom relief. Excessive, prolonged use can cause adverse effects like nutrient deficiencies (magnesium, calcium, B12), gut infections, altered microbiota, autoimmune disorders, etc.
The Root Causes for GERD
1. Gastrointestinal Dysbiosis & SIBO/SIFO
Dysbiotic gut microbiota produce gas, distension, and inflammation, increasing intra-abdominal pressure and promoting reflux.
Support: Gut healing strategies, antimicrobials (when needed), probiotics, and diet modification.
2. Gut Barrier Dysfunction (Leaky Gut): Increased gut permeability allows toxins and immune mediators to enter circulation, stimulating systemic inflammation that impairs esophageal and gastric function.
3. Dietary Triggers & Sensitivities: Foods like processed carbs, sugar, dairy, and gluten can feed dysbiosis or cause mucosal inflammation, worsening reflux.
4. Lifestyle & Stress: Chronic stress and sleep disturbances disturb autonomic balance, impairing gastric motility and LES tone.
5. Gastric Dysmotility and Helicobacter pylori: Abnormal gastric emptying or H. pylori infection can disrupt gastric acid regulation—sometimes reducing acid but causing dysregulation that predisposes to reflux.
Stomach acid is crucial for digestion, killing pathogens, and maintaining gut health. Prolonged suppression may promote dysbiosis, nutritional deficiencies, and immune dysregulation.
The Case for Root Cause Treatment
1. Repair Gut Microbiome & Barrier Function
Support probiotic and prebiotic intake, gut healing protocols, and avoid irritants (processed foods, food sensitivities).
2. Improve Digestion & Motility
Lifestyle modifications: Chewing well, eating smaller meals, avoiding eating late at night.
Prokinetics: Herbal (e.g., ginger, deglycyrrhizinated licorice) and lifestyle-based methods to enhance gastric emptying.
3. Address Postural & Lifestyle Factors
Elevate head during sleep.
Reduce stress, improve sleep hygiene, and avoid tight clothing.
4. Nutritional & Lifestyle Optimization
Support nutrients vital for gut health (magnesium, zinc, B-vitamins).
Reduce intake of artificial additives and inflammatory foods.
In Summary:
Antacids are useful for short-term symptom relief but do not target the underlying causes.
Chronic GERD often stems from dysbiosis, barrier dysfunction, lifestyle, and systemic inflammation. Addressing root causes promotes true healing, restores gut health, and reduces dependency on medications.
Mahesh Jayaraman Dr. Pramod Tripathi Dr Priti Nanda Sibal Dr Ruhi Agarwala ANURAG DALMIA Dr. Manjari Chandra 🍉Ryan Fernando®️ Subhendu Panigrahi Marcin Maciąg Dr. Deepali Gupta Anjali Mukerjee Dr Hitakshi Sharma, MD
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