Acid Reflux: it’s not what you think
Today, we’re delving into the often misunderstood world of acid reflux. Contrary to popular belief, approximately 90% of acid reflux cases are caused by low stomach acid (hypochlorhydria) - not an overproduction of acid. This means that the standard treatments many people rely on could actually be making the condition worse, not better.
Yes, you read that right. Antacids such as Gaviscon and Rennie, as well as proton pump inhibitors (PPIs) like omeprazole and lansoprazole, may be perpetuating your reflux cycle rather than resolving it.
Let’s explore why.
Recognising acid reflux symptoms beyond heartburn
Acid reflux - also referred to as heartburn or, in more chronic cases, gastro-oesophageal reflux disease (GERD) - is typically associated with a burning sensation in the chest, regurgitation, and indigestion. However, acid reflux presents in many lesser-known ways. These symptoms often go unrecognised, misdiagnosed, or dismissed as 'normal' - when they’re not!
Here are some of the more surprising signs of acid reflux:
- Chronic sinusitis and nasal congestion – Acidic vapour can irritate nasal passages.
- Recurrent ear infections – Acid vapour may reach the Eustachian tubes, causing irritation and infection.
- Sore throats, post-nasal drip, and persistent coughs – Ongoing inflammation from reflux.
- Excess mucus production – The body overcompensates to protect against acid irritation.
- Nasal polyps and benign vocal chord growths – Inflamed tissue attempting to heal.
- Fatigue and poor resilience – Resulting from nutrient malabsorption.
- Hair loss, immune dysfunction, and low energy – Due to reduced absorption of key minerals such as iron and zinc, and inadequate protein digestion.
The real cause? Too little stomach acid
The stomach is the powerhouse of digestion. While carbohydrate breakdown begins in the mouth, the stomach is where true digestive processing takes place. When food enters, the two muscular rings that seal the stomach - one at the top (the lower oesophageal sphincter) and one at the bottom (the pyloric sphincter) - clamp shut. Acid is then produced, enzymes are activated, and food is churned into a semi-liquid substance called chyme. Once this process is complete and the environment reaches an appropriately acidic state, the pyloric sphincter opens and chyme moves into the small intestine.
But if the stomach doesn’t produce enough acid - due to stress, ageing, medication, or poor diet - food lingers. Pressure builds, pushing contents upwards into the oesophagus. That’s your classic indigestion, heartburn, and reflux. Fermentation begins, causing bloating and belching - especially after protein-rich meals.
Other classic symptoms of low stomach acid (hypochlorhydria) include:
- Frequent burping and bloating
- IBS-like symptoms (diarrhoea/constipation, gas)
- Intense fullness after eating, especially protein
- Undigested food in the stool
- Persistent fatigue and nutrient deficiencies
So what do most people do? They reach for an antacid, further suppressing stomach acid that was already too low. While this may relieve symptoms in the short-term, it exacerbates the problem in the long run. As stomach acid continues to decline, symptoms worsen, leading people to stronger medications like PPIs (e.g. omeprazole, lansoprazole, esomeprazole). These medications block the stomach’s ability to produce acid altogether, which is sometimes necessary (e.g., after surgery or when taking NSAIDs), but they are meant for short-term use - days or weeks, not years.
This cycle continues until medications lose effectiveness. People then experience “rebound reflux” when trying to stop, as the stomach struggles to restart acid production. This is why a supported withdrawal process under professional guidance is vital.
At-Home Test: the Bicarbonate Burp Test
You can try this non-clinical test to get a sense of your stomach acid levels.
You’ll need:
- ¼ tsp bicarbonate of soda (baking soda)
- 150–200 ml cold water
- Stopwatch
Instructions:
- Do this on an empty stomach, first thing in the morning (no food or water beforehand).
- Dissolve the bicarb in the water and drink the mixture.
- Sit calmly and start your timer.
- Wait for a natural burp (not forced).
Results:
- 0–2 mins: Normal acid levels
- 2–5 mins: Possible suboptimal levels
- 5+ mins/no burp: Likely low stomach acid
For more accurate results, repeat for three consecutive mornings.
So what causes low stomach acid in the first place?
Several factors can suppress stomach acid production:
- Chronic stress – Activates the sympathetic nervous system (fight or flight), reducing digestive function.
- Ageing – Acid production naturally declines with age.
- Poor eating habits – Eating too quickly, while distracted, or on the go reduces digestive stimulation.
- Dental issues – May lead to a preference for softer foods, minimising chewing and its role in triggering stomach activity.
- Small intestinal bacterial overgrowth (SIBO) – Can result from low acid, allowing harmful microbes to proliferate.
- Long-term use of PPIs or antacids – These suppress acid and impair digestive function over time.
The good news
The stomach is remarkably adaptable. Given the right support and consistent guidance, it can be “retrained” to produce acid efficiently again.
Good digestion isn’t just about what you eat - it’s how you eat that makes all the difference. If your gut has been feeling sluggish, uncomfortable, or unpredictable, it might be time to go back to basics and nourish your digestion from the ground up. Here’s my ultimate guide to optimising your digestion naturally…
1. Begin with Bitter Foods
Kickstart every meal with a small amount of bitter foods to get those digestive juices flowing.
Try my easy (and delicious) trick —> Keep a jar of mixed nuts and seeds on your table - think pumpkin, sunflower, hazelnuts, Brazil nuts - with a few whole spices like fennel, cumin, and coriander seeds mixed in. Chew a teaspoonful before eating to prime your digestion.
Or have a bit of celery, some rocket or a radish. Crunchy, peppery and priming too!
2. Chew, Chew, Chew!
Thorough chewing isn’t just polite - it’s essential. The simple act of chewing well tells your stomach, “Hey, food’s coming - start producing acid!” Rushing through meals or swallowing chunks whole? That’s a recipe for indigestion.
I make my clients lay themselves a proper place setting at the table, sit down and romanticise their meals a bit. And hey presto….they start to feel better!
3. Ditch the Distractions
Eating while watching TV or scrolling your phone? It’s time to break up with multitasking at mealtimes. Digestion is a diva - it demands your full attention. So sit down, breathe, and enjoy the act of nourishing your body.
4. Breathe with Each Bite
Try my three-chew trick: Take a bite, chew, and breathe in gently through your nose. Notice where the breath goes. If it’s stuck in your chest, put your fork down and keep chewing while encouraging your breath to travel deeper, expanding your ribs out and back. This relaxes the diaphragm and supports smooth, effective digestion.
5. Set the Mood with Soft Lighting
Candles or warm, gentle lighting at dinner aren’t just romantic - they cue your nervous system to shift into “rest and digest” mode. This helps your body prioritise digestion over stress or stimulation.
Reflux support
If acid reflux or bloating are regular visitors, here are five natural tools to help encourage healthy acid levels and protect your gut:
1. Raw Apple Cider Vinegar (ACV)
ACV can help acidify the stomach and support digestion thanks to its natural fermentation. It also contains enzymes and friendly bacteria.
- How to use: Mix 1–2 teaspoons into a small glass of water and sip with meals.
- Avoid if you have ulcers, active gastritis, or ongoing heartburn until that inflammation is healed. See slippery elm further down.
2. Betaine Hydrochloride (HCl) an example product I recommend would be this one
This supplement supports stomach acid production directly.
- How to use: Start with one capsule at the start of a protein-rich meal. Increase gradually until you feel a gentle warming sensation - then reduce by one capsule. That’s your dose. Over time, your stomach should kick back in.
- Not suitable if you’re on NSAIDs or have ulcers until inflammation is resolved.
3. Digestive Enzymes - an example product I would recommend would be this one
When acid is low, enzyme production often is too. Supplementing can give your body the tools it needs to break down proteins, fats, and carbs more effectively.
- Look for: A broad-spectrum blend with protease, amylase, and lipase. Bonus points for formulas with herbs like ginger, peppermint, and gentian for extra digestive support.
4. Slippery Elm - an example product I would recommend would be this one
A wonderfully soothing herb, slippery elm coats and protects irritated tissues in the oesophagus and stomach.
- How to use: Take 15 minutes before meals if you experience frequent heartburn. Follow up with other digestive aids like betaine or enzymes when eating.
- Try it as a tea or powder for easier absorption - especially if you struggle with capsule digestion.
5. Zinc Carnosine - an example product I would recommend would be this one
This nutrient duo helps repair the stomach lining and encourages healthy acid production. Zinc is often depleted when stomach acid is low, so replenishing it is key.
- Dose: at least 30 mg per day in divided doses, always after meals.
In summary…
Bear in mind that all of the above should be tallied alongside dietary tweaks too, but these will be unique to each individual’s food preferences, history and behaviours. If this is something you’d like more personalised guidance on, you can book a confidential quick consult with me here for an immediate discussion, or opt for the Liebling Health Digestion Package (call or email based), for personalised nutritional and lifestyle guidance over four sessions, in addition to any targeted supplements.