Thread by @questmoosa

Almost 50% of the population experiences GERD / reflux symptoms

Yet most of what we’re told about it is wrong

Here’s what really causes these issues and how to resolve them

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Most traditional healthcare professionals will tell you that reflux / GERD is from too much stomach acid

They’ll probably prescribe PPIs and send you on your way

But when you actually understand the issue you’d realize too much acid isn’t the problem at all

Why would we be lied to about this?

Well with almost half the population struggling with this, the pharmaceutical industry makes over $14 BILLION annually from PPIs that are prescribed

Since PPIs do nothing to resolve the issue (more on that later), they have customers for life

So what’s really going on with GERD?

There seems to be two main issues

1) Muscular malfunction

2) Abdominal pressure

1) Muscular malfunction

The lower esophageal valve separates the esophagus from the stomach

This valve should typically only open for food or liquids consumed to pass into the stomach or when belching

But muscles controlling this valve can malfunction contributing to GERD

With this valve malfunctions, it allows acid back into the esophagus where it causes damage and discomfort

So regardless of how much stomach acid there is, this malfunction allows the acid back into the esophagus

Having too much acid isn’t the issue

This is why modern medicine’s approach to GERD isn't effective

Treating someone by lowering their stomach acid with PPIs does nothing to address the root causes

It often leads to a long list of other health issues as a result

2) Abdominal pressure

Too much stomach acid isn’t the problem - it’s usually the opposite - not enough stomach acid

So when you use PPIs to further lower stomach acid, your digestion is destroyed

This increases the risk of pathogen overgrowth significantly

There are also tons of other problems with PPIs

Metabolites can deposit in kidneys causing immune response/kidney dysfunction

Cognitive impairment by interfering with neurotransmitter reuptake

Increased risk of heart attack

Reduced bone health by impairing calcium absorption

Low stomach acid can cause a long list of issues that contribute to build up of intra-abdominal pressure

This pressure pushes acid up toward the esophagus

When we combine this pressure with the muscular dysfunction of the lower esophageal valve, we get GERD

So what are common causes of this pressure buildup and muscular dysfunction?

There seems to be 3 main contributors:

1) Low acid / poor digestion

2) Muscle weakness / inflammation

3) Fermentation

𝗦𝘁𝗼𝗺𝗮𝗰𝗵 𝗔𝗰𝗶𝗱

When you have low stomach acid, you do not digest your food well

This can lead to many issues like:

Partially digested food rotting causing pathogen overgrowth

Malabsorption / nutrient deficiencies

Intestinal permeability

One of the roles of stomach acid is to inhibit bacterial overgrowth

These bacteria can produce gasses, which lead to the pressure build up contributing to GERD

Additionally, when food isn’t fully digested it begins to ferment creating more gas and more pressure

If we’re not digesting our food well, we’re not absorbing the nutrient from the food properly

This can lead to nutrient deficiencies such as zinc and B vitamins

Both of these nutrients are important for stomach acid production, leading to a cycle of continually lower acid

Malabsorption and pathogen overgrowth can both contribute to intestinal permeability

Permeability (aka leaky gut) can increase the risk of a long list of serious conditions

One of those being chronic inflammation, which we’ll see soon has a role in GERD

𝗠𝘂𝘀𝗰𝗹𝗲 𝗪𝗲𝗮𝗸𝗻𝗲𝘀𝘀 / 𝗜𝗻𝗳𝗹𝗮𝗺𝗺𝗮𝘁𝗶𝗼𝗻

When the muscles involved in digestion are weak, it can contribute to GERD

The muscles that contain acid in the stomach must provide adequate confinement (especially in the diaphragm)

People who lack adequate strength in these muscles can experience issues such as lower esophageal valve malfunction, which we saw directly causes GERD

Additionally, inflammation can cause organ and muscle dysfunction (like in the stomach and diaphragm)

Chronic inflammation can cause poor circulation which can cause muscle weakness and malfunction

So a combination of both weakness and inflammation can directly result in a malfunction of muscles required to confine stomach acid leading to GERD

𝗙𝗲𝗿𝗺𝗲𝗻𝘁𝗮𝘁𝗶𝗼𝗻

When stomach acid is low, we’re unable to fully digest foods that we should have no problem digesting

But there are foods that even with sufficient stomach acid we can’t fully digest, such as fiber

Since these foods cannot be fully digested, they are fermented in the gut

This produces gas, which contributes to intra-abdominal pressure that can lead to GERD

So, if I had GERD here’s what I’d do

1) Eat & digest well

Prioritize a good balance of quality protein, fats and carbohydrates

This would include reasonable amounts of fiber for proper digestion/microbiome balance, but not a high-fiber diet leading to excessive fermentation

In addition to eating well, I’d also do the following to improve digestion:
- Not over eat
- Chew well
- Walk after meals
- Stretching/yoga before/after eating
- Eat in a relaxed state

2) Boost acid

We know low stomach acid is a common contributor to GERD & PPIs worsen that

To boost acid I would:
- occasional ACV use with big meals
- no liquids with meals
- marinate meat (in citrus juice)
- boost B vitamins, zinc & sea salt
- manage stress

3) Strengthen muscles

Building up diaphragmatic muscles, which ensure that gastric contents remain in the stomach and prevent regurgitation

To do this I’d focus on deep breathing exercises and core strength training

Thank you for reading.

If you want to take it further,
consider reading the true cause and solutions for your gut problems 👇:

substack.com/@questmoosa/no…