A Functional Medicine Approach to Acid Reflux

TLDR: Acid reflux happens when stomach acid backs up into the esophagus, and one of the most common causes is actually low stomach acid. Long-term use of acid-blocking PPIs like omeprazole has been linked to health risks, so stopping should be done slowly with a provider. Eating slowly and calmly, managing stress, and checking for causes like magnesium deficiency, H. pylori, or low thyroid can help.

Acid reflux  - sometimes very painful, and at other times, it shows no symptoms at all. The on again off again nature of the symptoms are always a sign of a problem that should be resolved. In 2019, over the counter 24 hr antacid pills were the 7th most commonly filled prescription medication in the US. It is also available over the counter, thus many more of us are taking it than we have record of. Americans have a big problem with acid reflux.

There is also a larger problem with the drugs used to treat it. You may have heard of the popular over the counter brands like: Prilosec OTC, OmePPi, and Zegerid. These are all forms of Omeprazole. 

Omeprazole, among many other drugs, is from a class of medications called proton pump inhibitors, or PPI’s. As the name implies, these drugs inhibit a process which significantly suppress stomach acid production. To sufferers, this sounds great in theory, but in reality we see that this acid suppression causes significant problems including osteoporosis, Vitamin B12 deficiency, kidney disease, possible increased risk of dementia and circulatory issues. 

Stopping a PPI takes time and a slow weaning process to avoid a rebound effect of acid production (ouch!). A functional medicine provider or health coach can help you with this. 

Acid reflux is actually, as the name implies, acid refluxing from the stomach into the esophagus. The stomach lining is specially designed to stand up to the acidity of hydrochloric acid (stomach acid), the esophagus is not. Thus it causes pain or if in small amounts, creates inflammation or increased mucus production which causes a dry cough or constant clearing of your throat. 

The most common cause of acid reflux is actually low stomach acid secretion. 

Some of the main causes of low stomach acid are: 

• magnesium deficiency- this is the most common cause. Most of us do not get enough magnesium in our diet. 
• high cortisol from stress- there is an 80-90% reduction in stomach acid when a person is in a “fight or flight” state 
• poor eating hygiene - most people eat too fast or under rushed, stressful conditions
• H Pylori infection- this is an overgrowth of a bacteria found in the gut
• hypothyroid

The importance of having adequate stomach acid can not be understated.  Maintaining a healthy acid balance is crucial  for our body to break down protein and create amino acids, absorb vitamins and minerals from food and support a healthy environment for our vital gut flora to grow.

One of the most effective ways to reduce or resolve acid reflux issues is to start paying attention to how you eat.  Sit down for a meal, take a deep breath and relax for just a minute before you start to eat.

Acid Reflux FAQs

What causes acid reflux?

Acid reflux happens when stomach acid flows back up from the stomach into the esophagus. The stomach lining is built to handle strong acid, but the esophagus is not, so the acid causes burning, inflammation, a dry cough, or frequent throat clearing.

Can low stomach acid cause acid reflux?

Yes. Low stomach acid is one of the most common causes of acid reflux. Common reasons for low stomach acid include magnesium deficiency, high cortisol from stress, eating too fast, H. pylori infection, and an underactive thyroid.

Is it safe to take omeprazole long term?

Omeprazole (sold as Prilosec OTC, OmePPi, and Zegerid) is a proton pump inhibitor, or PPI, that strongly lowers stomach acid. Long-term acid suppression has been linked to osteoporosis, vitamin B12 deficiency, kidney disease, and a possible increased risk of dementia, so it is worth reviewing long-term use with a provider.

Can I stop taking my PPI on my own?

It is best not to stop suddenly. Stopping a PPI too quickly can cause a rebound in acid production. A functional medicine provider or health coach can guide you through a slow weaning plan.

How does stress affect acid reflux?

Stress raises cortisol, and stomach acid can drop by 80 to 90 percent when the body is in a "fight or flight" state. That drop can lead to poor digestion and reflux. Learn more about how cortisol affects your body.

How can I reduce acid reflux naturally?

Start with how you eat. Sit down for meals, take a deep breath, and relax for a minute before you start to eat. Eating slowly, managing stress, and supporting overall gut health can help reduce symptoms.

When should I see a provider for acid reflux?

See a provider if your reflux keeps coming back, causes pain, or you rely on antacids or PPIs to get through the day. A New Way Healthcare in Jacksonville Beach, FL takes a functional medicine approach to find the root cause. Call (904) 299-0373 to schedule a visit.