Reflux that keeps coming back is usually not just an acid problem — it’s a pressure and mechanics problem.

In the video, Dr Vikki Petersen explains why getting "relief" from an antacid is not addressing the core of the problem. In fact, it's perpetuating it.

Acid blockers (PPIs and H2 blockers) reduce stomach acid and can decrease the burning sensation. That can be appropriate short-term, especially with esophagitis. But these medications do not address the root cause of reflux - it isn't too much acid. 

It's actually a pressure problem. When pressure within your abdomen increases, stomach emptying slows, or a hiatal hernia develops, stomach contents can move upward regardless of acid level. Lowering acid may reduce symptoms, but it does not correct the mechanical dysfunction being caused by the pressure.

Why stomach acid matters. Why do you need acid in your stomach?

• Protein digestion begins in the stomach
• It's a detergent/disinfectant that kills bad organisms.
• Absorption of minerals only occurs due to the presence of acid: e.g. calcium, magnesium, iron, zinc
• Release and absorption of vitamin B12 and folate

Potential risks associated with long-term acid suppression

Long-term PPI use has been associated in the literature with:

• Increased risk of nutrient deficiencies (B12, magnesium, iron)
• Higher rates of C. difficile infection - a bacterial infection that can be life-threatening
• Altered gut microbiome - more bad bacteria present in the gut than good bacteria leading to inflammation, mood disorders, and more.
• Increased fracture risk - osteoporosis due to lack of calcium absorption
• Kidney injury (acute and chronic)
• Increased risk of respiratory infections, e.g. pneumonia

These associations do not mean every patient will experience harm, but they highlight that acid suppression can have negative health impacts across many organs and systems.

Addressing the root contributors
Long-term improvement often requires evaluating:

• Intra-abdominal pressure (belly fat, chronic straining due to constipation)
• Diaphragm function and breathing mechanics
• Hiatal hernia alignment
• Delayed stomach emptying
• Dysbiosis or SIBO
• Food triggers and inflammatory load

The goal should not simply be eliminating the burn.
The goal is restoring function and integrity.

References
1. Lam JR, et al. Proton pump inhibitor and histamine-2 receptor antagonist use and vitamin B12 deficiency. JAMA. 2013
2.Hess MW, et al. Systematic review: hypomagnesaemia induced by PPIs. Aliment Pharmacol Ther. 2012. 
3. Yang YX, et al. Long-term PPI therapy and risk of hip fracture.
JAMA. 2006. 
4. Xie Y, et al. Long-term kidney outcomes among PPI users without intervening acute kidney injury. J Am Soc Nephrol. 2017
5. Janarthanan S, et al. Clostridium difficile–associated diarrhea and PPI therapy: meta-analysis. Am J Gastroenterol. 2012
6. Kahrilas PJ, et al. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008.

#acidreflux #hiatalhernia #rootcausemedicine 
Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video.
The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary.

Many viewers ask what to do next if symptoms persist. 
Our licensed medical team at Root Cause Medical