Despite millions of Americans receiving this frustrating and painful diagnosis every year, acid reflux is still a commonly misunderstood health issue. You might already know that it is caused by stomach acid splashing up into the esophagus instead of remaining in the stomach, where the acid-resistant stomach walls protect us from feeling its harsh effects. Logically, we think that this means we have too much stomach acid. However, it is much more commonly caused by too little stomach acid.
Rethinking low stomach acid as the root cause behind acid reflux completely changes how we think about treating it––including what foods we can safely eat, what vitamins and supplements may be useful, and what medications we should use or avoid.
In this article, we will review what acid reflux is, what really causes it, and what you can do to relieve the painful symptoms associated with it.
What is acid reflux?
Most people feel acid reflux as an intense burning sensation in their chest, usually after eating heavy, spicy, or fatty meals. Other symptoms may include difficulty swallowing, a feeling of a lump in your throat, coughing, burping, or even regurgitation.
The American College of Gastroenterology estimates that over 60 million Americans experience acid reflux at least once per month, and over 15 million experience acid reflux symptoms every day. 
The populations that more commonly experience acid reflux symptoms include the elderly and pregnant women. (For very different reasons––the elderly tend to have lower stomach acid, whereas pregnant women, of course, have a baby physically pushing up on their stomach and esophagus. Guess which one is easier to fix!)
Chronic acid reflux––defined as two or more episodes of acid reflux per week––is known as GERD or gastro-esophogeal reflux disease. If not treated properly, GERD can lead to severe inflammation in the esophagus, causing restriction, painful ulcers, and an increased risk of esophageal cancer.
What causes acid reflux?
A common misconception: high stomach acid
For many years, doctors have prescribed medications for acid reflux like proton pump inhibitors (Nexium, Prilosec) or H2 receptor blockers (Pepcid) that lower stomach acid, assuming reflux is caused by high stomach acid levels. While these medications do typically provide some relief, they have serious long-term side effects such as vitamin deficiencies and bone loss, and they don’t treat the actual root cause of the issue––low stomach acid. 
As Dr. Jonathan Wright explains in his book Why Stomach Acid Is Good for You , “What has come to be called––incorrectly––‘acid indigestion’ is almost always associated, not with too much stomach acid, but with too little.” Decades of scientific and clinical research backs up his claim, especially research showing the connection between aging and low stomach acid. 
In some rare cases, reflux symptoms can be caused by too much acid, which can also cause painful ulcers, inflammation, and digestive distress. But more often than not, the real issue can be low stomach acid.
The real cause: low stomach acid
Dr. Wright explains that over 90% of acid reflux cases are caused by low stomach acid.
How does low stomach acid = acid reflux symptoms like heartburn, gas, and indigestion? Basically, adequate stomach acid allows us to digest our food and anything else we might inadvertently swallow, like the microbes on our food. With proper stomach acid levels, these microbes die quickly and the rest of our digestive system remains safe from harm.
But without enough stomach acid, microbes multiply where they aren’t supposed to––in the stomach and small intestine––causing increased pressure on the stomach and lower esophageal sphincter (LES), which is supposed to prevent our food from coming back up into the esophagus. With acid reflux or GERD, the gas and pressure coming from the overpopulated microbes in the stomach as well as undigested food forces the LES open in the wrong direction, allowing even small amounts of stomach acid to enter the esophagus and cause heartburn. 
Therefore, additional stomach acid is needed to properly digest food, kill unfriendly microbes, and relieve pressure/bloating on the stomach and LES. Then, acid reflux and GERD symptoms subside and stay gone. Unlike acid suppressing medications, supplementing additional stomach acid and increasing the body’s natural acid production actually heals acid reflux and GERD.
How to get rid of acid reflux
To reduce acid reflux symptoms and ultimately get rid of them for good, there are many natural means we can use to support the body’s innate production of stomach acid.
Acid reflux diet
To start, you can try to avoid these foods that increase reflux symptoms:
- Processed/packaged foods
- High-carb foods
- Fatty foods, especially those with highly processed, inflammatory oils (soybean, sunflower, canola, etc.)
- Spices, such as cayenne, chili powder and pepper
- Carbonated beverages
- High amounts of grains and starchy carbs such as bread, rice, potatoes, and squashes (Experiment to see if you can tolerate lower amounts of these.)
- Any other trigger foods that are unique to you––pay close attention to what you eat!
At the same time, you can add in specific foods that reduce reflux symptoms and promote healing in the lining of the stomach and esophagus:
- White and/or fatty fish such as trout and salmon (preferably wild caught)
- Animal protein such as chicken, beef, and pork (preferably grass fed and grass finished)
- Eggs (preferably… you get the idea.)
- Fruits, such as bananas, berries, apples, pears, melons, peaches and more, in moderation
- Green vegetables, such as broccoli, brussels sprouts, green beans, asparagus and spinach, usually cooked for easier digestion. (Again, pay close attention to your symptoms and reactions to different foods.)
- Herbal tea, such as chamomile, marshmallow root, and ginger, as well as green tea
- Bitter foods, such as arugula, dark chocolate, coffee, cranberries, dandelion greens and more that support digestion and stomach acid. Some of these foods are also thought to make reflux symptoms worse, so go with what your body tells you.
Acid reflux lifestyle changes
It’s easy to see how diet can directly impact acid reflux symptoms, but lifestyle change is just as critical to healing.
Stress is always a factor in any health issue, so take care to practice activities that lower stress and promote the parasympathetic or “rest and digest” state. These might include meditation or guided meditation, or a creative hobby you enjoy.
Also make sure to practice slow mindful eating: put down your fork between each bite, and chew each bite at least 20 times. This not only signals to your body that it is in a safe place, but it is also the first step in digesting your food as digestive enzymes in your saliva begin to break down proteins, fats, and carbs. Take the time to savor and taste your food without distractions like sitting in front of the TV or scrolling through your phone. Perhaps easier said than done these days, but your body will truly thank you for it.
You can also incorporate low-intensity exercise into your routine like walking, yoga, or simple stretches. All of these activities promote a more relaxed body and mind and better digestion.
Add in Betaine HCl with meals
For additional support, you may want to consider taking betaine hydrochloric acid, or betaine HCl, with meals. Betaine HCl is bioidentical stomach acid––equal to what your body makes naturally––and it can help you more easily digest meals, especially fats and carbohydrates, along with careful nutritional consideration and lifestyle support.
You may also follow this up with our Magnesium Carbonate 30 minutes to one hour after taking betaine HCl (and after your meal) to soothe the stomach and promote relaxation in the body after extra acid has been introduced.
Other natural remedies for acid reflux
Digestive bitters have been used for centuries in Ayurvedic and Chinese medicine to stoke the digestive juices and encourage better nutrient absorption. Some of these include gentian root, dandelion root, fenugreek, ginger, and fennel, among many others. You can find digestive bitters in a tincture or in tablets that you take before a meal. 
Herbal teas can also soothe the lining of the stomach and esophagus and promote better digestion. Some common herbal teas for acid reflux relief include camomile, slippery elm, marshmallow root, licorice, and ginger tea. Some people find mint tea to make their symptoms worse, so listen to your body’s signals and sip on whatever feels best for you.
Stomach acid is incredibly important for our digestion and overall health!
The bottom line: maintaining optimal stomach acid levels is key to preventing acid reflux and GERD. Acid reflux is almost certainly caused by low stomach acid rather than high stomach acid, according to years of clinical research. While acid-suppressing medications may provide temporary relief, they will ultimately cause the problem to get worse if left untreated.
Stomach acid is also the first line of defense in protecting the rest of our digestive system from pathogens and toxins that we ingest with our food and drink, so having healthy acid levels is essential to our overall and long-term health.To learn more about digestion, check out our blog How to Improve Fat Digestion and Absorption.