Send us a text

If you're a mouth breather, you could be creating an environment for acid reflux and hiatal hernia.

Mouth breathing, due to congestion or inflammation can contribute to a weakened diaphragm, altering its mechanics, increasing intra-abdominal pressure, and leading to poor posture.

Nasal breathing, or normal breathing, engages the diaphragm fully and rhythmically, helping to prevent acid reflux and hiatal hernia.

Chronic mouth breathing encourages shallow chest breathing using the upper chest and accessory muscles (the muscles in your neck and shoulders). This then leads to under use and weakening of the diaphragm over time, reducing its effectiveness and a clamp (known as a pinch-cock) on the esophagus where it passes through the diaphragm. This clamp or valve is necessary to prevent acid reflux from occurring. 

Mouth breathers have inefficient core and brath coordination, which can impair abdominal pressure regulation, a key factor in preventing acid reflux and hiatal hernia. Due to this, abnormal pressure spikes can occur in the abdomen especially during coughing , lifting or straining, all putting stress on the hiatal (opening) area of the diaphragm.

Mouth breathing, posturally speaking, is often associated with a forward head posture and poor spinal alignment, leading to stress on the vagus and phrenic nerves (the phrenic travels to the diaphragm), thus affecting diaphragmatic function.

During sleep, mouth breathing can worsen sleep apnea or snoring, both of which involve repeated pressure surges into the chest and abdominal cavity. This can worsen acid reflux and a hiatal hernia.

The solution is to get to the root cause of why the mouth breathing is occurring. This can be do to a variety of factors including: food sensitivities, inflammation of the nose or sinuses (the cause needs to be identified. e.g. mold, SIBO, etc), sympathetic nervous system overdrive (vagus related), and more.

Mouth breathing can truly aggravate acid reflux and hiatal hernia, but getting to the root of it isn't difficult. If you struggle with it we'd be happy to see how best to resolve it.

If you'd like help we're here for you. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.

#acidreflux #rootcausemedicine #hiatal hernia

Send us a text

Your body has a natural Anti-Reflux Barrier designed to prevent reflux from occurring – it's composed of 3 structures:

1. LES (lower esophageal sphincter)

2. Crural diaphragm – tendons from the lumbar spine that form a “crura” (like another sphincter) which surrounds the opening where the esophagus passes through the diaphragm and prevents reflux – it lies above the LES by just a small distance.

3. Phrenoesophageal ligament – anchors to the esophagus and the diaphragm both, and holds the lower esophagus and the GE (gastro-esophageal) junction in the abdomen. It prevents the GE junction from sliding upwards into the chest.
These 3 structures work together to maintain a high-pressure zone that prevents reflux. In other words, they’re exacting more pressure externally than the stomach exerts, thus keeping acid inside the stomach.
How does the pressure zone get compromised? It’s due to intra-abdominal pressure that overwhelms it. 

Due to:
Constipation - ~20% of adults
Gas and bloating from: IBS, food sensitivities, SIBO – 40% based on 2025 study
Fatty liver or pancreatitis – 25% of adults have fatty liver
General inflammation – 35% of adults
Leaky gut – 80 to 90% of adults
Obesity – excess abdominal fat builds up intra-abdominal pressure – 74% are overweight and 43% are obese.

Discovery is that of those with acid reflux, 75 to 100% have a hiatal hernia.
This is a mechanical problem which is corrected with a comprehensive look at the underlying root cause:
Gut
Diaphragm
Vagus nerve

It's the analysis of what factors are affecting you that allows us to resolve this problem naturally. Hopefully resolving the problem completely and allowing you to wean or discontinue your PPI.

If you'd like help we're here for you. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.


#acidreflux #leakygut #hiatalhernia

Send us a text

Are you taking a PPI (proton pump inhibitor) to address the symptoms of your acid reflux?
Please note that acid reflux does not occur due to excess acid, but rather pressure inappropriately placed upon your stomach, forcing the acid up your esophagus and thus the symptoms of reflux.

The decreased acid in your stomach creates problems for your liver, particularly leading to liver inflammation and non-alcoholic fatty liver.

The diminished acid levels allow bacteria to overgrow in your stomach and small intestine. These bacteria produce endotoxins that get into your bloodstream and travel to your liver (via the portal vein) and trigger liver inflammation, fat accumulation, and eventually fatty liver. Those who are at higher risk for this include people who are obese, have diabetes or are consuming higher than moderate levels of alcohol.

Another way the liver is affected is through bile. Bile is produced in the liver and housed in the gallbladder but there are actually two pools of bile. The primary is produced in the liver, but the secondary is formed by the gut bacteria. Of course when the gut bacteria are imbalance and more bad bacteria are present, such as the condition with a PPI, less secondary bile if formed. 

This results in less effective fat digestion and a higher incidence of diarrhea or irritation which can damage colon cells, increase inflammation and causes increased colon cancer risk. 

Due to fat malabsorption a person will not absorb fat-soluble vitamins like A, D, E, and K.

In summary, taking a PPI puts you at risk of malabsorption of important vitamins, toxic bile production, diarrhea which can be mistaken for IBS, fatty liver, colon inflammation and increased colon cancer risk.

And this is just one of the more than 10 risks associated with taking PPIs.

If you are on a PPI and would like to get to the root cause of your acid reflux and not have to concern yourself with the many dangerous side effects of these drugs, we are here for you. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.

#acidreflux #fattyliver #rootcausemedicine

Send us a text

If you have acid reflux but still suffer with symptoms despite using medication, you may suffer from bile reflux. You can have both acid reflux and bile reflux, or you can have bile reflux only. Let's delve into it.

Symptoms of bile reflux include many of the same symptoms of acid reflux. They include:
upper abdominal pain or burning
nausea after eating
cough or sore throat if the bile reaches the upper esophagus
vomiting (may be yellow-green if it contains bile)
unresponsive to PPIs - this medication only decreases acid, not bile

Complications of bile reflux are also similar to acid reflux:
gastritis
Barrett's esophagus
increased risk of stomach and esophageal cancer

What's important to know about bile is that it's highly alkaline, on the opposite spectrum of the pH scale from stomach acid. However, it's like a detergent and when it's present in parts of the body where it shouldn't be, it breaks down cell membranes and mucus membranes, making it highly inflammatory and destructive. Hence its ability to cause the complications just reviewed.

Bile is produced in your liver, stored in your gallbladder and it is secreted into the upper small intestine. Those are its normal destinations. If bile enters the stomach, esophagus or throat however, it's going to cause major damage.

Causes of bile reflux include:
Gallbladder surgery
Weakened sphincter between the stomach and small intestine (duodenum) - this is due to ulcers, inflammation and/or vagus nerve irritation
Gastroparesis - slow stomach emptying. There are many causes for this such as: type 1 diabetes, vagus nerve malfunction, hiatal hernia surgery, gallbladder surgery, low thyroid, autoimmune disease, depression, anxiety, chronic reflux, chronic PPI use and SIBO.

Addressing bile reflux is extremely important because of its caustic damaging nature, its frequency of misdiagnosis as acid reflux, plus the danger of utilizing treatments that don't work.

In order to address the root cause one needs to optimize gut health, normalize inflammation, rebalance vagus nerve function, engage in a healthy diet and balance hormone function. Of course the root causes may vary individual to individual and you may require one or two of the above mentioned factors, but not the others. That is why all our programs are customized to each person. We'll identify what needs to be done for you.

If you've been suffering with these symptoms and want to resolve them rather than band-aiding them with drugs, we'd be happy to help. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.

#bile #acidreflux #rootcausemedicine

Send us a text

I'm frequently asked if H2 blockers are safer than PPIs.
Let's take a look.

To review the dangers of PPIs first, they are associated with the following:
Nutrient deficiencies
Gut microbiome disruption
Infections
Depression and Anxiety
Loss of libido
Kidney problems
Osteoporosis
Stroke, heart attack risk
Stomach cancer, and more...

H2 blocks work by this mechanism: They block histamine-induced acid secretion in your stomach. Histamine triggers your stomach cells (parietal cells) to release acid by activating H2 receptors. These drugs block that mechanism.

H2 blockers are less potent than PPIs and are best for mild to moderate reflux or nighttime symptoms. Overall they are used to accomplish moderate acid reduction.

The acts faster than PPIs (within 1 hour) but lasts for a shorter period of time (6 to 12 hours vs 24 hours with a PPI).

Side effects are: headaches, constipation, diarrhea, fatigue, dizziness, muscle aches and confusion in the elderly.
Long-term side effects include:
Vitamin B12 deficiency (same as a PPI)
Increased risk of infections, though less severe than with a PPI
Kidney and mood changes are considered rare
Microbiome disruption - all less than with a PPI

Another factor is that tolerance builds over time with H2 blockers reducing their effectiveness.

As you can see, there are still dangers, and for those with more severe reflux, H2 blockers won't provide the relief needed.

The best goal is to identify the root cause of the reflux and thereby be able to wean off the medication. The side effects are too severe to be ignored.

If you'd like help we're here for you. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.

#acidreflux #hiatalhernia #rootcausemedicine

Send us a text

Macadamia nuts can help you have a healthier gut which everyone should be interested in, but they also improve mental clarity, stabilize your blood sugar, improve insulin sensitivity and may help you lose weight.

Macadamia nuts and nuts in general help act as a prebiotic, feeding particular bacteria in your gut, helping to keep nice diversification of your microbiome.

They help in mental clarity because they are high in omega-3 fatty acids while being low in omega-6s. Eating more monounsaturated fats (like macadamia nuts) is associated less cognitive decline.

If you're someone who's digestive tract gets upset eating nuts you may find no trouble with macadamia nuts for this reason: macadamia nuts are low in phytic acid which is the substance nuts use to protect themselves from predators but this same substance can cause gut upset. Due to the very thick, hard shell on macadamia nuts, they have no phytic acid, making digestibility high.

Macadamia nuts are also very high in fiber, another helpful benefit for your gut.

Surprisingly, nuts can be potentially less caloric because when we chew them we're only breaking down the first layer of cell wall, resulting in diminished overall absorption of the fat in the nut. 

A mice study in the Journal Mediators of Inflammation showed a very interesting correlation with macadamia nuts and weight loss. This was in mice remember, but it's promising. The study had group fed a high fat diet and a control diet. The high fat group showed increased inflammation and enlargement of their fat cells, as compared to the control group. But when they switched the high fat group to macadamia nut oil, all their inflammation reversed and their fat cells shrunk.

Blood sugar is controlled better and insulin sensitivity rises with a diet higher in monounsaturated fatty acids as well.

Dose: about 1/4 cup or 1 ounce of nuts.
Thomas DeLauer goes into great depth about all the studies associated with these benefits if you want a deeper dive. 

If you are ready to get healthier and want some assistance we're here for you. Call us for a consultation: 727-335-0400.

Send us a text

If you suffer from acid reflux or have a hiatal hernia, you've likely been tested for H. pylori (Helicobacter Pylori), a bacteria found in the stomach which is the number one cause of stomach and duodenal (top part of your small intestine) ulcers.

The most common way to test for it is during an endoscopy, although stool testing can be done as well.

The symptoms of H. pylori are a bit vague and can mimic acid reflux, making it often missed. Unfortunately a chronic infection has a lot of dangers associated with it so you want to test for it accurately.

Symptoms include: bloating, discomfort in the upper abdomen, nausea, early satiety (meaning you feel full quickly), and acid reflux symptoms. If you have a hiatal hernia these symptoms are very familiar to you, hence the need to make the distinction. You can certainly suffer from all 3: a hiatal hernia, reflux AND an H. pylori infection, but we can't miss the infection.

H. pylori creates many of the same side effects associated with PPIs. Due to its effect upon the acid producing cells in your stomach you can malabsorp important nutrients including magnesium, folate, vitamin B12 and iron. 

I decided to film this video because I've been asked several time why testing doesn't agree. An endoscopy won't show the infection, but a stool test will. Of course that leaves one wondering which test is correct.

Let's look at the two tests and how they compare.

An endoscopy misses H. pylori 30 to 50% of the time. 
Why? It's due to something called sampling bias. The biopsy is taken from certain parts of the stomach only (the antrum and body - which is the lower stomach and main "body"). The problem with this is 2-fold. There are other parts of the stomach not addressed: the cardia, fundus and pylorus. 

Plus, H pylori can colonize in a patchy distribution meaning you can be in the right area but still miss it. It's especially difficult if the patients uses PPIs (that's a big one considering their widespread use), has stomach cancer or atrophic gastritis. The latter can be caused from autoimmune diseases such as Hashimoto's thyroiditis and Type 1 diabetes. Atrophic gastritis increases your risk of stomach cancer.

Endoscopic biopsy is very susceptible to false negatives (you have the infection and it fails to detect it) with patients who have taken a PPI, antibiotic, or bismuth during the past 2 to 4 weeks!

Let's move on to stool testing. Note: All stool testing is NOT created equal. Therefore, please ensure that any stool test your doctor orders for you covers all the points I'm about to discuss. Typically they do not through a conventional medicine doctor, but double check.

1. A benefit of stool testing is that it captures H pylori shed from the entire stomach lining.
2. The right test will utilize PCR DNA testing that is able to detect H. pylori with a high sensitivity and specificity, even at low levels. This is exactly what you want.
3. Stool testing is not affected by the use of PPIs, antibiotics or bismuth (think Pepto-bismol).
4. DNA testing can detect genetic material of the bacteria from live and recently dead organisms. Again, a more sensitive detection.
5. The "right" testing detects antibiotic resistance genes. e.g. Clarithromycin and other medications commonly used to treat the infection. If you particular H. pylori infection is resistant to the common drugs used to treat it, you won't successfully eradicate it. These tests prevent useless treatment from occurring.
6. H. pylori is a known carcinogen. The "right" testing looks at virulence factors (genes). Most common is: cagA - linked to a higher cancer risk. chronic gastritis also puts you at higher risk for stomach cancer. And vacA, associated with ulcer formation.
Many think H. pylori is a

Send us a text

PPI medication is very commonly prescribed for acid reflux but it's important to know its various side effects, of which there are many.

Today I'll review the increased risk of infections, what types and the mechanisms involved.

Your stomach's acid is a key part of your body's natural defense system against pathogens, both bacteria and virus alike.  When the acid level is decreased more pathogens survive and can reach your intestines and respiratory tract.

1. Clostridium difficile (C diff) - this is one of the most well documented infections associated with PPI use and its symptoms include severe diarrhea, colitis, and it can be life-threatening. While the risk is highest for the elderly and those in hospital, it's also a risk factor for those on a high-dose of PPIs or those who have taken the drug for more than 1 year.

2. Small intestinal bacterial overgrowth (SIBO) - this occurs when bacteria overgrow in the small intestine which is supposed to be mostly sterile. Symptoms include bloating, bas, diarrhea and malabsorption.

3. Pneumonia - two types of involved: Bacterial and Chemical. 
Chemical pneumonia results from aspirated acid into the lungs due to acid reflux. The acid causes inflammation of the lung tissue.
Bacterial pneumonia is a result of aspirating saliva or food that as inappropriately moved up the esophagus. With someone suffering from GERD this could occur while sleeping or lying down, or as a result of LPR which I describe in the video as well as previous videos on the topic.

4. Food-borne Illnesses - food poisoning can result in Salmonella, Campylobacter or Listeria infections due to insufficient acid in the stomach.

Those at risk include:
PPI use for more than 1 year
High dose PPI use
Elderly
Those in hospital
Individuals taking antibiotics

The most important step you can take is to resolve the root cause of your acid reflux and get that treated so that we can wean you down and hopefully off the PPI completely.  We have good success in this area.

If you take a PPI and would like to discover the underlying root cause of your acid reflux, we'd be delighted to help. The best next step is to call us for a consultation and we can then determine if what we do is a good fit for you. Call us at 727-335-0400.

Please subscribe to the channel if you enjoy the content. It really helps others to see it.

#ppi #acidreflux #rootcausemedicine

Send us a text

If you have Hiatal Hernia Syndrome you may have been told you have a shortened esophagus. A shortened esophagus can put you at risk for, or worsen, a hiatal hernia.

I'm going to review why it happens and what you can do about it.

One cause is due to chronic reflux and the acid has damaged your esophagus to such an extent that it goes beyond inflammation of the esophageal tissues and becomes scar tissue (fibrosis). Scar tissue does not have the "elasticity" of healthy tissue and it also tightens and pulls. Therefore, this chronic situation can result in a shortened esophagus that is difficult to repair.

However, and here's the good news, there is another contributor to tightening and shortening that is reversible. We look to your vagus nerve that has several different functions that can all affect your esophageal length.

The vagus nerve is responsible for the smooth muscle of your esophagus to engage in peristalsis which is a wave-like motion that moves food and liquid down your esophagus.

The vagus nerve is also responsible for the tone of your LES (lower esophageal sphincter), which is basically a valve that resides below your diaphragm level near the base of the esophagus which allows food and liquid to pass through into the stomach, but it also closes to prevent anything from refluxing in the wrong direction.

LES tone is thought to be compromised in Hiatal Hernia and now you know a cause that you can do something about. Tips are coming!

Further there are longitudinal muscles that run vertically in your esophagus that temporarily shorten it through contractions when you're swallowing. This is of course transient, but it can become more chronic and result in excessive contraction, and thereby shortening, with dysfunctional vagal tone.

You can see there are several routes by which abnormal vagal tone can affect the length of your esophagus and put you at risk for developing or worsening a hiatal hernia.

Tips to normalize vagus nerve tone: (These are explained in depth in the video)
1. cold exposure
2. gargling, humming, singing
3. laughing
4. moderate intensity exercise
5. eye gazing

Lastly I mentioned a vagal nerve stimulator and a discount code we offer to patients. It's called Truvaga and if you're interested I can send you the link for the discount.

If you have chronic GERD and want to prevent irreversible shortening of your esophagus we'd be happy to help The best next step is to reach out for a consultation and we can then determine if what we do is a good fit for you. Call us at 727-335-0400.

Please help more people have access to these videos by subscribing and liking the video.
I appreciate you!

#GERD #hiatalhernia #rootcausemedicine

Send us a text

Patients often ask how they can tell between "legitimate" digestion issues and anxiety. They want to know if the cause of their symptoms is "just anxiety" or something else.

With Hiatal Hernia Syndrome common symptoms include acid reflux, heart palpitations, shortness of breath and anxiety. But too often, while the reflux can be confirmed, visits to specialists fail to find anything wrong with your heart or lungs, and then when the complaint of anxiety or panic attacks is added to the list of symptoms, you can be labeled a patient with "health anxiety", thus dismissing your symptoms. It is insinuated that, other than your reflux, your symptoms are likely "all due to stress", meaning it's "all in your head".

This is not only unfair to you it's inaccurate.

The truth is the Hiatal Hernia Syndrome does cause anxiety via 2 routes: the spasming of your diaphragm which causes your nervous system to secrete stress hormones because of the decreased oxygen, and because of irritation to your vagus nerve which can also cause anxiety.

It's a physical and neurological cause that is very real and the good news is, very treatable, naturally. The solution is to get to the root cause of what's creating your hiatal hernia, which isn't difficult to do.

Now what if anxiety is a symptom you have in isolation? Meaning you've been an "anxious" person for quite some time but don't have any of the other symptoms we've been discussing.

Here at Root Cause Medical we would evaluate the following 7 factors:
1. Diet - we know the standard American diet is full of chemicals and artificial ingredients that can cause anxiety, brain fog and mood swings, to name a few.
2. Food sensitivities - if you look at gluten, which is a common food sensitivity, it's interesting to note that it's neuroinflammatory and can most definitely cause anxiety. Realize that can be the main symptom, despite having little to no digestive complaints.
3. Genetics - SNPs ("snips") that you inherit from Mom and Dad can influence your ability to deal with stress and make you less able to clear stress chemicals, as an example. I tell my personal story in the video... But know that specific nutrition for specifics SNPs can calm the waters and no longer have you feeling anxious.
4. Toxins - we evaluate for many toxins, but as an example, mold toxins pass across the blood brain barrier and can cause brain inflammation and anxiety as a result.
5. Microbiome - we know that there is a strong gut-brain connection and that an imbalanced microbiome can be responsible for psychological symptoms such as anxiety.
6. Hormonal imbalance - it is well understood that hormonal imbalance can create the symptom of anxiety, along with others.
7. Lifestyle Basics - in this category we address such things as sleep hygiene, exercise, hydration and more.

I could write a book on the 7 topics above, but suffice to say that evaluation of the factors pertinent to you and your health history can be very impactful when getting to the root of anxiety.

Anti-anxiety medications are too freely used to "band-aid" symptoms while doing nothing to address the root cause. Their side effects also concern me as they include aggravating digestion with causing upset stomach, nausea, along with loss of libido, weight gain, emotional blunting (people say they feel like a robot and it's scary), and suicidal thoughts.

The good news is that much can be done to get to the root causes of why you may suffer anxiety, whether it's secondary to hiatal hernia or not.

If you've been suffering with anxiety, we'd love to help. You can reach out to us for a consultation and we'll let you know if we're a good fit for you. Call us at 727-335-0400. We're here to help.

Please subscribe to this channel if you enj