Yes you read that right.
Most people assume acid reflux means ‘too much acid’, but it’s usually acid in the wrong place, driven by pressure, stress, poor signalling, and inefficient digestion such as constipation or poor bile health. When we understand how the stomach, liver, nervous system, and hormones interact, we can treat the root causes instead of merely masking symptoms.
Ready to find out more? …
The valve in the middle: the importance of the lower oesophageal sphincter (LES)
Between your oesophagus and stomach sits the lower oesophageal sphincter (LES), a muscular ring that opens to allow food through, then closes to keep digestive juices inside the stomach. When the LES is weak, compressed, or poorly signalled, reflux follows.
‘Reflux isn’t about excessive acid… it is acid in the wrong place’
Acid and pepsin (a main protein-digesting enzyme released in the stomach) escaping upward can inflame tissue in the oesophagus. Studies suggest pepsin itself triggers an inflammatory cascade in that tissue, which may drive much of the pain associated with reflux.
The stomach has thick, protective mucous lining, so that the acid does not ‘burn it’, or the pepsin does not ‘eat it’, but the oesophagus does not have this wondrous mucous layer.
The digestive chain: stomach, liver, bile, colon
Reflux is also not just a stomach problem, think of your digestive system as a long traffic lane. If there’s a traffic jam lower down (constipation, gunky bile, poor motility), pressure builds upstream, right back toward the stomach and LES. That pressure can literally push acid and pepsin upward, worsening reflux.
Digestion is an intricate interplay of organs and signals
When you chew and swallow, hormonal and nerve signals prompt the release of acid in the stomach, and shortly after, bile from the liver/gallbladder and enzymes from the pancreas. These systems depend on each other.
Bile isn’t optional, not only does it emulsify fats, it also supports microbial balance and helps maintain upper gut motility. If bile flow slows or becomes congested (from low fibre, oestrogen shifts, stress, or gallbladder removal, hormonal shifts such as thyroid or menopauseMenopause is often described as the point at which a woman has gone twelve consecutive months without a menstrual period. Whilst technically correct, it does not provide the bigger ‘picture’. Menopause is a transition, more than an event. For many women, the journey begins years earlier during perimenopause, when hormones start to fluctuate and symptoms such as hot flushes, sleep disturbances, anxiety, brain fog, mood changes, joint pain, weight gain, and irregular periods may begin to appear. It can feel as though the body has decided to ‘pack up and go home’.), fats linger and pressure rises, pushing the LES open.
Pro tip: For more information on how the liver and gallbladder work together in digestion, check out our liver and gallbladder, dynamic duo webinar and cleanse.
Also think constipation, because if there is a traffic jam down under, it will impact the traffic further along the ‘highway’. In essence, constipation or sluggish bowel movements can result in acid reflux.
READ MORE ON CONSTIPATION HERE
The low-acid paradox: why many with reflux actually underproduce acid
Contrary to popular belief, people with chronic reflux often have too little stomach acid (hypochlorhydria) and without adequate acid:
- Food, especially proteinProtein is one of the three main macronutrients, alongside fats and carbohydrates, yet for many years it was often the forgotten member of the trio. More recently, protein has become something of a celebrity in the nutrition world, appearing in everything from snack bars and cereals to coffee and desserts. Whilst the marketing can sometimes get a little carried away, the truth is that protein is essential for human health. Every cell in the body relies on it. Protein helps build and repair tissues, supports immune function, forms enzymes and hormones, transports nutrients, and helps maintain muscle mass, particularly as we age., lingers too long, creating pressure
- The hormonal ‘handshake’ to the gallbladder and pancreas weakens
- Bile and enzyme flow slows
- The gut becomes a playground for fermentation and gas
- Nutrient absorption (B12, iron, magnesium, zinc) reduces
Signs you might have low stomach acid:
- Protein feels heavy or ‘sits like a brick’
- Bloating, belching, or nausea after meals.
- Weak nails
- Skin congestion
- Fatigue
- Loss of appetite for meat
- Feel worse for having meat
Why antacids and PPIs (proton pump inhibitors) are not the long-term answer
Firstly, these medications were never intended for long-term use, as long-term use starts a whole cascade of unwanted chronic health issues from anaemia, chronic fatigue, antibiotic resistant H.Pylori.
Suppressing acid can ease pain temporarily, but long-term use has costs:
- Nutrient malabsorption (iron, B12, magnesium, calcium)
- Increased infection risk (acid normally kills pathogens)
- MicrobiomeWhen you hear the word microbiome, you probably think of the gut. Fair enough, it gets most of the attention. But what if we told you that microbes are not just hanging out 'down under'? They are everywhere. There is the oral microbiome living in your mouth, the skin microbiome covering every inch of your body, the urogenital microbiome, the lung microbiome, and, of course, the celebrity of the microbial world, the gut microbiome. These tiny organisms are not unwanted guests infact, truth be known, we are their guests. They are part of you, which helps keep you alive. shifts such as SIBO
- Greater fracture risk, bone loss
- Blunted digestive signalling over time
- Diabetes
- Cardiovascular disease
If you are using a PPI, don’t stop abruptly. Rebound hyperacidity is awful. Instead, plan a taper under supervision with a qualified practitioner, while you restore digestive health.
Step 1: calm and protect the mucosal lining
Before rebuilding the digestive system, soothe inflamed tissue:
- DGL (deglycyrrhizinated licorice) is protective, anti-inflammatory
- Marshmallow root & slippery elm will coat tissue
- Inner-filleted aloe vera juice is cooling and supports the mucosal lining
You can use these until symptoms ease, then phase into stronger support aids.
Step 2: rebuild eating hygiene (foundation of digestion)
- Pause, take 1–2 calming breaths before the first bite
- Sit upright, eliminate distractions (yes including the phone)
- Chew 20–30 times per bite, let saliva start digestion
- Hydrate between meals and sip lightly during meals
- Stop, when you feel about 80% full to leave room for churning
- Stay upright for at least an hour after eating, better still go for a walk to help with blood sugar regulation
These behaviours reduce mechanical stress and help the LES maintain its firmness.
Step 3: reignite digestive signalling
- Digestive bitters (herbs or bitter greens) stimulate acid, enzymes, and LES tone
- Apple cider vinegar or lemon water (if tolerated) before meals
- Digestive enzymes and bile support (ox bile, taurine, bitters) if gallbladder function is weak
- Cell saltsCell salts, also known as tissue salts or biochemical salts, were developed by the German physician Dr Wilhelm Schüßler in the 19th century. They are prepared from naturally occurring mineral compounds and are used in highly diluted doses to support the body's ability to utilise and regulate minerals. The twelve original cell salts include familiar minerals such as calcium, magnesium, potassium, sodium, iron, and silica, each traditionally associated with different tissues and functions within the body., natrum phosphoricum, magnesium phosphoricum and natrum muriaticum to support smooth muscle function (including the LES) as well as stomach acid production
Step 4: relieve pressure and restore bile flow
Reduce pressure:
- Eat earlier in the evening (finish 2–3 hours before bed)
- Sleep on your left side or elevate the head of your bed
- Wear loose clothes around the waist
Support bile and liver:
Liver loving foods
- Use real, quality fats (olive oil, avocado, egg yolk) to prompt bile release
- Eat fibre (vegetables, fruits, seeds, whole grains) to carry bile out of the system
- Include bitter foods and liver-supportive herbs (such as dandelion root, beet greens)
- Move regularly, even short walks after meals help motility
- Avoid alcohol, refined sugars, and highly processed oils that thicken bile
If you have had your gallbladder removed, bile still flows, but out of sync. Also the cause of the gallbladder removal is usually still not addressed. Is it due to epigenetics, junk food, insufficient water intake, or oestrogen dominance? etc.
Supplementation and bitters help mimic normal signalling. You can find more on the liver and gallbladder in our Dynamic Duo webinar.
Step 5: refine triggers without fear
Temporarily reduce known LES irritants (tomato sauces, citrus, coffee, black tea, chocolate, mint, fried/spicy foods, alcohol, soda). Once symptoms fade, reintroduce one item at a time and monitor your response.
Add in a simple 3-week elimination for dairy or gluten, then reintroduce slowly. Many people find dairy is a hidden trigger in reflux.
Step 6: align the nervous system
Digestion is never just digestive; your brain and stress patterns are always involved.
When your nervous system is in fight-or-flight, digestive secretions fall by 30–60%. That means even perfect food can’t be processed well. To flip the switch:
- Begin each meal with 1–2 deep, slow inhales and exhales (let your body know you are SAFE)
- Remove stressors, screens, and conflict from the table
- After meals, avoid intense mental focus, take a walk, stretch, or rest
These practices are not optional extras; we believe they should be part of 21st century living.
Step 7: investigate deeper when progress plateaus
If symptoms persist despite good habits:
- Assess for hiatal hernia (structural issue)
- Test for H. pylori (can damage lining, disrupt acid balance)
- Evaluate SIBO or methane-dominant overgrowth (fermentation pressure)
- Consider gallbladder removal / bile reflux (especially if fat digestion is off)
- Screen thyroid, adrenal and chronic stress physiology (often linked to low acid)
Functional testing helps you address root patterns rather than mask symptoms.
Acid reflux is rarely a simple ‘too much acid’ issue. It’s a system-level problem where the LES, pressure dynamics, digestive signals, bile flow, and the nervous system must all work in alignment. If you can soothe irritation, reduce pressure, rebuild nerve signals, restore bile health, and reduce stress, your body often heals itself.
You are not broken. The paths to healthy digestion are simple: chew slowly, support your liver and bile (begin with our Dynamic Duo), and invite calm around your meals.
In a nutshell:
- LES under pressure: a tight belt, oversized meal, or rising gas from fermentation acts like your shortest, least forgiving path, which presses the LES open
- Bile health matters: bile emulsifies fats, clears cholesterol, supports microbial balance, and maintains motility. Stagnant bile is a strong ally of acid reflux
- Low acid not too much acid: many reflux-prone individuals under-secrete, not over-secrete. Low acid leads to stagnation, pressure, and valve failure
- Don’t drop your PPI cold turkey: rebound acid bursts when stopping too quickly. Taper slowly while introducing supporting strategies
At the New School, we teach our students to look at the WHOLE person, their lifestyle, their eating habits, the food on their plate, their relationship dynamics, and more. And we have just provided you a snippet into the way they are taught to address acid reflux, aka heartburn.
To health!
From the team at the New School Of Nutritional Medicine
Learn about the Founder & Principal of the New School of Nutritional Medicine, Dr Khush Mark PhD, HERE.
