Think GERD is just about too much stomach acid? Not so! Learn the true root causes of reflux, from low stomach acid to microbiome imbalance—and why acid blockers may not be the long-term solution you think they are.
Most people think they know what causes GERD: spicy food, tomato sauce, maybe coffee or chocolate. Just avoid acidic stuff, right?
It seems intuitive—but it’s not actually true.
In reality, acid is often a symptom, not the root cause. These two infographics from Dr. Kristina Carman help make sense of this often misunderstood condition. If you or someone you love is dealing with reflux, this could change how you think about healing it.
Root Causes of GERD You May Be Missing
Here are some of the real, functional issues that often underlie chronic reflux:
Low Stomach Acid (Hypochlorhydria)
Too little stomach acid leads to poor protein digestion, bacterial overgrowth, and weak LES tone—the valve that keeps acid out of your esophagus.
H. pylori Infection
This common infection suppresses acid, causes inflammation, and slows digestion, all of which worsen reflux.
SIBO (Small Intestinal Bacterial Overgrowth)
Fermentation in the small intestine creates gas and pressure, pushing contents back toward the esophagus.
Bile Reflux & Gallbladder Issues
It’s not just stomach acid—bile can back up into the stomach and esophagus, causing serious irritation.
Poor Motility
Sluggish digestion leaves food sitting in the stomach too long, increasing pressure. Stress, vagus nerve dysfunction, and thyroid issues can all play a role.
Food Sensitivities & Inflammatory Diet
Gluten, dairy, sugar, alcohol, and processed foods contribute to gut irritation and LES dysfunction.
Microbiome Imbalance (Dysbiosis)
An unhealthy microbial environment in the gut leads to inflammation, poor digestion, and reflux-friendly conditions.
Mythbusting GERD: What You’ve Heard vs. What’s Real
Many people have been told GERD = too much acid. But that’s a myth.
Here’s what the reality looks like:
| Myth | Reality |
|---|---|
| GERD is caused by too much stomach acid. | GERD is often caused by too little stomach acid, poor motility, and microbial imbalance. |
| Acid-suppressing meds fix the problem. | These meds can relieve symptoms but often worsen digestion over time. |
| GERD = acid problem. | GERD = function problem. Think LES tone, motility, vagus nerve, mucosa, microbiome. |
| PPIs are the solution. | Addressing root causes brings lasting relief. |
If this flips your understanding of reflux upside down, you’re not alone. Most people have been taught the wrong story about GERD. But, knowledge is power, especially when it comes to your gut. Nearly everyone experiences reflux at some point, but the severity and root causes vary widely.
We’ll be sharing more GERD guides soon—because lasting relief starts with the right information. Stay tuned!
