If you suffer with acid reflux you are in good company. But acid reflux doesn't respond well to lowering acid levels. The proof?

Educational content reviewed by licensed APRN medical staff. Not personal medical advice.

In the video, Dr Vikki Petersen explains why "blaming" the acid in your stomach is the wrong approach. Millions continue to suffer despite taking a standard acid reducing medication like PPIs.

Up to 40% of GERD patients report dissatisfaction and have incomplete or no response to a standard PPI dose.
Up to 55% continue to have persistent symptoms despite “optimal therapy”.

What’s going on:
Your stomach is supposed to contain acid. It kills bad organisms, begins protein digestion, and absorbs minerals and  B12. 
Reflux is not due to too much acid -real problem is acid in the wrong location - your esophagus.

Why? The anti-reflux barrier fails.

Why?
1.Digestion slows, stomach remains full, food ferments, gas builds and pressure rises, pushing stomach upward.
2.The diaphragm loses its coordinated support of the LES, becomes flattened, and less able to prevent reflux.
3.Vagus dysfunction - leads to fight or flight resulting in shallow breathing, diaphragmatic excursion decreases, decreased tone of LES, slowed gastric emptying, 
4.Hiatal hernia - stomach elevates and compromises anti-reflux barrier
5. H pylori -bacterial infection. More susceptible if older or taking PPI.
Symptoms of H. pyrlori are often mistaken for reflux:  
Stomach burning or gnawing pain, nausea, early fullness, worse on an empty stomach.  
H. pylori infection can cause anti-reflux barrier to fail

H. pylori is leading cause of atrophic gastritis globally. 
Stomach lining thins, loses gastric gland cells, leads to low acid, B12 deficiency and risk of stomach cancer.

Gastric gland cells produce HCl, enzymes, protective mucus to prevent the stomach from digesting itself. 

Strains: CagA - most dangerous, higher risk of ulcer, cancer 
VacA - all H pylori carry the gene - s1 more toxic, s2 less toxic
The strain matters as much as the infection.

If reflux isn’t just acid problem, what do you do?
1.stop assuming acid is the enemy. Goal is restore normal stomach function.
2. support digestion so stomach can empty properly. e.g.
real food, adequate protein, hydration
3. reduce pressure. e.g. handle constipation, bloating, tight clothing, large late meals
4. restore coordination between diaphragm and esophageal sphincter. e.g. nasal breathing, diaphragmatic breathing, posture awareness, daily movement 
5. support vagal tone. e.g. handle chronic stress, shallow breathing, poor sleep, fight or flight 
6.identify upstream disruptors. e.g. H. pylori, low stomach acid, hiatal hernia,  testing microbiome, ruling out mold, viruses, heavy metals, and food sensitivities.
Reflux improves when the body as a coordinated system works together again-not when acid is simply suppressed.

References:
1.El-Serag HB, et al. Update on the epidemiology of gastro-oesophageal reflux disease.. Gut, 2014.
2.Pandolfino JE, et al. Mechanical properties of the lower esophageal sphincter and crural diaphragm. Gastroenterology, 2007.
3.Sifrim D, et al. Transient lower esophageal sphincter relaxations and reflux. American Journal of Medicine, 2001.
4.Farmer AD, et al. The role of the vagus nerve...Nature Reviews Gastroenterology & Hepatology, 2014.
5.Martinucci I, et al. Esophageal impedance-pH monitoring... Neurogastro & Motility, 2018.
6.Malfertheiner P, et al. Helicobacter pylori infection. Nature Rev Dis Primers, 2017.
7.Cover TL, et al, H pylori VacA, ...Nat Rev Micro, 2005.
8.Hatakeyama M. H pylori CagA...Nat Rev Cancer, 2004.

#acidreflux #guthealth #hiatalhernia #rootcausemedicine 

Disclaimer: The information provided in this video is