Acid Reflux Causes: Why Heartburn Isn’t Always Too Much Acid

How low stomach acid, gut dysfunction, and medications drive reflux—and how to relieve it long term

Person experiencing chest and upper abdominal discomfort associated with acid reflux and heartburn symptoms

You finish a meal and instead of feeling satisfied, you feel bloated, uncomfortable, or burning—sometimes in your chest, sometimes in your throat. Maybe you’re belching more than usual, waking up at night with reflux, or relying on antacids just to get through the day.

Most people are told these symptoms mean they have too much stomach acid. But for many patients, that explanation doesn’t fully add up—especially when acid-suppressing medications stop working, symptoms rebound, or digestion continues to worsen over time.

Research and clinical experience increasingly show that chronic acid reflux is often not an acid overproduction problem, but a dysfunction of digestive signaling, stomach acid balance, and the lower esophageal sphincter (LES) (1,2). When stomach acid is insufficient, food is not properly broken down, gastric emptying slows, and pressure builds inside the stomach. That pressure—combined with impaired pH-dependent closure of the LES—allows stomach contents to move upward into the esophagus, creating the familiar symptoms of reflux (2,3).

Seen through this lens, acid reflux is less about suppressing acid and more about restoring normal digestive physiology—addressing why acid is moving in the wrong direction in the first place (4).

Gut Health & Digestive Restoration



Why Am I Getting Acid Reflux?

Your esophagus—the muscular tube connecting your mouth to your stomach—relies on a critical valve called the lower esophageal sphincter (LES). Under normal conditions, the LES opens to allow food into the stomach and then closes promptly to prevent stomach contents from flowing backward. When this valve fails to close fully, opens too frequently, or loses proper pressure, reflux symptoms can occur (2).

A key but often overlooked detail is that the LES is pH-sensitive. It relies on adequate stomach acid to receive the signal to close appropriately. When stomach acid is too low, that signal weakens. This helps explain why acid-suppressing medications may temporarily blunt symptoms yet worsen reflux physiology over time by further reducing the acid needed for proper LES function.

If the LES remains open or reopens too soon after swallowing, acidic stomach contents can move upward into the esophagus. The resulting burning or pain is not simply discomfort—it reflects chemical injury to esophageal tissue, which is not designed to withstand exposure to gastric acid (3).

Stomach acid normally has a very low pH (approximately 1.5–3), a range your stomach lining is structurally equipped to tolerate. The esophagus, by contrast, has a near-neutral pH (~7) and lacks the same protective mucosal barrier. Repeated acid exposure can therefore damage esophageal cells over time.

With chronic reflux, this ongoing injury may trigger cellular changes in the lower esophagus, where normal squamous cells begin transforming into intestinal-type cells—a process known as metaplasia. In advanced cases, this can progress to esophageal adenocarcinoma (3).

Beyond discomfort, untreated or poorly managed acid reflux can therefore lead to significant downstream complications. This is why understanding why reflux is occurring—and addressing the underlying dysfunction rather than suppressing symptoms alone—is clinically essential.



Acid Reflux Causes: Genetics or Lifestyle?

Acid reflux rarely has a single cause. In most cases, symptoms reflect an interaction between anatomy, physiology, lifestyle factors, medications, and gut health—all of which influence pressure inside the stomach and the function of the lower esophageal sphincter (LES).

Some factors are structural or hormonal and harder to modify. Others are lifestyle-driven and highly responsive to targeted intervention. Understanding which category applies to you is critical for effective, long-term relief.

Below are the most common contributors seen clinically.

Hiatal Hernia

One of the most frequent structural contributors to acid reflux is a hiatal hernia. This occurs when part of the stomach pushes upward through the diaphragm into the chest cavity via the esophageal hiatus (4).

Small hiatal hernias are often asymptomatic. Larger hernias, however, can significantly disrupt LES function, increase reflux episodes, and raise the risk of complications such as Barrett’s esophagus (5–7). Hiatal hernias are more common with aging, tobacco use, and increased abdominal pressure.


Helicobacter pylori Infection

Helicobacter pylori is a gastric bacterium that alters stomach homeostasis by triggering inflammation and damaging acid-producing cells. Over time, this can reduce hydrochloric acid output, impair protein digestion, and delay gastric emptying (6).

As undigested food ferments, gas and pressure build within the stomach—mechanically forcing contents upward through the LES. This pattern often coexists with dysbiosis, SIBO, leaky gut, and food sensitivities, reinforcing reflux symptoms rather than resolving them.

This overlap helps explain why chronic reflux often presents alongside broader digestive complaints—particularly microbial imbalances explored in Gut Health & Dysbiosis: How Imbalances Like SIBO, Candida, and IBS Drive Chronic Symptoms.


Obesity and Abdominal Pressure

Excess abdominal fat increases intra-abdominal pressure, physically compressing the stomach and promoting reflux. Research consistently shows obesity as both a risk factor for developing GERD and a driver of symptom severity in those already affected (8).

Importantly, studies also demonstrate that reflux symptoms often improve with weight loss, particularly when central (abdominal) fat is reduced (8).


Pregnancy and Hormonal Shifts

During pregnancy, elevated progesterone levels relax smooth muscle throughout the body—including the LES. This hormonal effect, combined with increasing abdominal pressure, explains why reflux is common even in early pregnancy before significant weight gain occurs.


Tobacco Use

Smoking directly lowers LES pressure and impairs esophageal clearance mechanisms. It also disrupts mucosal defense and delays healing, making reflux both more frequent and more damaging (9).


Medications That Promote Reflux

Several medication classes are known to worsen reflux by reducing LES tone, slowing gastric emptying, or irritating the esophageal lining. Common examples include:

  • Calcium channel blockers and alpha-agonists

  • NSAIDs

  • Anticholinergic medications

  • Certain antidepressants and anxiolytics

  • Hormonal therapies containing progesterone (13,14)

In many patients, reflux symptoms improve only after identifying and addressing these medication-related contributors—particularly when drugs simultaneously impair digestion, alter gut motility, and increase toxic burden, as explored further in Your Gut, Hormones & Medications: How Common Drugs Disrupt Digestion and Detox Pathways.


Dietary Triggers

Food choices strongly influence reflux symptoms, particularly meals that are large, fatty, inflammatory, or difficult to digest. Common triggers include:

  • Fried and greasy foods

  • Chocolate

  • Coffee and alcohol

  • Tomato-based foods

  • Carbonated beverages

  • Citrus fruits

  • Spicy foods and peppermint

  • Sugar and refined carbohydrates (10,11)

While elimination alone is rarely sufficient, identifying and removing personal triggers can significantly reduce symptom burden.


Hypochlorhydria: A Common Underlying Pattern

Perhaps the most overlooked contributor to reflux is hypochlorhydria (low stomach acid). When acid levels are insufficient, digestion slows, fermentation increases, and gastric pressure rises—mechanically promoting reflux despite low acid output.

This pattern also contributes to dysbiosis, opportunistic infections, micronutrient deficiencies, and food sensitivities, creating a self-perpetuating cycle rather than resolving symptoms.

A Root-Cause Approach to Acid Reflux Relief

Conventional allopathic treatment for GERD most commonly relies on acid-reducing medications, including:

  • H2 receptor blockers, such as famotidine (Pepcid)

  • Proton pump inhibitors (PPIs), such as esomeprazole (Nexium) and omeprazole (Prilosec)

While these medications may temporarily reduce burning or discomfort, they do so by suppressing stomach acid, which can worsen the very physiology that contributes to reflux over time. As outlined earlier, acid reflux is not typically caused by excess acid production, but by impaired digestion and abnormal movement of stomach contents through the lower esophageal sphincter (LES).

Reducing stomach acid further promotes hypochlorhydria, which slows digestion, increases fermentation, and raises intra-gastric pressure—ultimately worsening reflux symptoms long-term rather than resolving them.

Stomach acid plays a critical and non-optional role in digestive and systemic health, including:

  • Protein digestion

  • Neutralization of ingested pathogens

  • Absorption of key minerals (iron, calcium, magnesium, zinc)

  • Activation and absorption of vitamin B12

  • Signaling for downstream digestive enzyme release

An expanding body of research shows that long-term use of PPIs and H2 blockers is associated with significant downstream risks (15–20), including:

  • Reduced absorption of vitamins and minerals
    (vitamin B12, vitamin C, calcium, iron, magnesium)

    Over time, acid suppression can impair the absorption of key vitamins and minerals, contributing to fatigue, bone loss, neurological symptoms, and immune dysfunction—patterns we see repeatedly in patients and explore in depth in The Most Common Nutrient Deficiencies—and Why They’re Often Missed.

  • Increased fracture risk, particularly in postmenopausal women

    This bone loss risk is not theoretical—long-term acid suppression interferes with calcium and magnesium absorption and has been linked to increased osteoporosis and fracture risk, especially in postmenopausal women, as explored further in Osteoporosis Prevention in Postmenopausal Women: A Functional & Traditional Chinese Medicine Approach.

  • Elevated risk of cardiovascular events

  • Gut dysbiosis and small intestinal bacterial overgrowth (SIBO)

  • Increased susceptibility to enteric infections such as C. difficile

  • Rebound acid hypersecretion upon discontinuation

  • Worsening reflux-like symptoms

  • Hypergastrinemia

  • Increased risk of gastric malignancy

  • Higher incidence of allergies, asthma, depression, and anxiety

  • Greater prevalence of autoimmune and inflammatory conditions, including rheumatoid arthritis, Graves’ disease, irritable bowel syndrome (IBS), Crohn’s disease, and ulcerative colitis

    This overlap is not incidental. Chronic acid suppression, gut dysbiosis, and impaired nutrient absorption can all contribute to immune dysregulation and intestinal inflammation—mechanisms we address in detail in Healing Inflammatory Bowel Disease Naturally: A Functional Medicine Approach.

Hypergastrinemia itself has been associated with an increased risk of stomach cancer (21). Additional research links prolonged acid suppression to chronic kidney disease and an elevated risk of dementia (22–24).

These findings underscore why symptom suppression alone is not a long-term solution for reflux—and why identifying and correcting the root causes of impaired digestion and LES dysfunction is essential for sustainable relief.



Natural, Integrative Strategies for Long-Term Reflux Resolution

But there are other safe and effective methods you can use to help counteract and resolve your heartburn. These include:

Acupuncture

Traditional Chinese Medicine (TCM) principles specify that acid reflux is often due to dysfunction of the stomach, liver, and spleen. 

TCM principles also notate that emotional swings or dietary irregularities weaken the liver’s ability to govern the free coursing of qi, impairs the spleen’s ability to transport and transform water and grain, and damage the stomach’s ability to maintain the balance of upward and downward bearing qi. 

Water and grain (i.e. food) in the stomach fail to be transformed into the essence and instead turn into toxic masses. If the downward flow of qi in the stomach is disturbed, it pathologically ascends. As a result, the stomach contents backflow into the esophagus. 

Reflux in TCM focuses on transforming turbidity, harmonizing the stomach, and restoring the downward bearing of stomach qi to prevent counterflow. This focus restores the normal functioning of the lower esophageal sphincter (LES), enhances gastric motility, and improves gastric emptying.

Acupuncture plus herbal medicine outperforms Omeprazole (Prilosec, Zegerid) for the treatment of acid reflux. (25) Acupuncture treatment for heartburn is a safe and effective acid reflux remedy. (26-28)

For a deeper look at how acupuncture influences gut motility, vagal tone, and digestive coordination in conditions such as reflux, bloating, and IBS, see Can Acupuncture Improve Digestive Issues? A Functional & Traditional Chinese Medicine Perspective.


TCM Herbs 

In TCM, gastrointestinal disorders are complex patterns of imbalance characterized by both excess and deficiency: excess refers to the stomach heat (inflammation and rising of stomach acid), and yin deficiency refers to the damaged mucosa of the digestive tract. 

This condition may be caused by external factors such as infection, alcohol, smoking, drugs, or internal conditions, e.g. stress. 

Therefore, herbs are used in this formula to clear heat, regulate liver qi, strengthen the stomach to restore its descending function, and restore normal digestive functions.

TCM herbal formulas have demonstrated therapeutic effects comparable to omeprazole in relieving GERD symptoms, while avoiding many of the adverse effects associated with long-term acid-suppressing medications (29).


Herbs/Supplements

A healthy gastric mucosal lining protects the GI tract from the damaging effects of stress, bacteria, and other irritating physical and chemical substances. Various herbs and supplements can support the integrity of the mucosal lining, such as:

  • Zinc Carnosine — A unique compound that appears to enhance mucosal integrity in the stomach. (30,31)

  • Slippery Elm — It’s reported to cause stimulation of nerve endings along the GI tract, leading to beneficial mucus secretions. (32, 33)

  • Marshmallow — A high-mucilage-containing ingredient that forms a demulcent gel when consumed orally, marshmallow has been used traditionally in many cultures for various maladies, including the support of intestinal mucosal membranes. (34)

  • Aloe Vera — The polysaccharide content of aloe gel is thought to be responsible for supporting a healthy inflammatory response in the GI tract. (35)

  • Deglycerized Licorice — The roots and rhizomes of licorice are used for a wide range of therapeutic applications, including the reported use of enhancing gastric mucus secretions to support GI health. (36)

    In vitro research suggests that licorice flavonoids have a beneficial impact on Helicobacter pylori (H. pylori) activity in the GI tract, and animal studies show that deglycyrrhizinated licorice (DGL) is effective in the alleviation of ulcerated gastric mucosal damage. (37)

  • L-glutamine — A free-form amino acid, L-glutamine supports gastrointestinal health through its vital role in maintaining mucosal integrity. 

L-glutamine is also involved in the production of secretory immunoglobulin A in the intestines, contributing to the immune barrier function of the intestinal mucosa. (38)

  • Okra — The pod contains a soft tissue that exudes a mucilaginous (long-chain polysaccharide) juice when cooked, linking okra’s effectiveness as a demulcent agent to its formation of a soothing film over inflamed mucous membranes. (39)

When used strategically, botanical medicine and targeted nutraceuticals can support mucosal healing, motility, and digestive signaling—but dosing, timing, and combinations matter, which is why these therapies are most effective when guided through Herbal Medicine & Nutraceutical Therapy rather than applied generically.

Lifestyle Changes That Alleviate Acid Reflux

Lifestyle factors play a far greater role in acid reflux than most people realize. As with many chronic health conditions, daily habits can either worsen reflux physiology—or significantly reduce symptoms when addressed consistently.

One of the advantages of lifestyle-based strategies is that they support digestion without suppressing stomach acid, making them an important foundation for long-term relief.

Weight management and abdominal pressure

Excess body weight—particularly around the abdomen—increases intra-abdominal pressure and promotes reflux. As discussed earlier, weight loss is consistently associated with reduced reflux symptoms. In addition, avoid tight or restrictive clothing around the waist, as external pressure on the abdomen can further impair lower esophageal sphincter (LES) function.

Stress reduction

Stress is a frequently underestimated contributor to digestive disorders. Acute and chronic stress can alter gastric secretion patterns, disrupt motility, and worsen reflux symptoms (12). Stress also interferes with vagal tone and parasympathetic signaling, both of which are critical for proper digestion and LES coordination. Addressing stress is therefore not optional—it is foundational.

Avoid tobacco use

Smoking significantly increases reflux risk by lowering LES pressure, impairing mucosal healing, and delaying gastric emptying. Quitting smoking can meaningfully reduce symptom severity and improve esophageal recovery. For individuals who struggle with nicotine dependence, nervous system–based support may help—explored further in How Acupuncture Can Help You Stop Smoking Naturally.

.

Optimize sleep position

Body position during sleep has a meaningful impact on reflux frequency, particularly for individuals with nighttime symptoms. Lying flat can allow stomach contents to move upward more easily, especially when gastric emptying is delayed or lower esophageal sphincter (LES) tone is impaired.

Elevating the head of the bed—ideally using a wedge rather than stacked pillows—helps reduce gravitational backflow of stomach contents into the esophagus and can significantly improve overnight symptom control.

Sleep quality and circadian regulation also influence digestion, motility, and nervous system balance, which is why optimizing sleep hygiene and positioning plays a larger role in reflux management than many people realize—explored further in Why Poor Sleep Is More Harmful Than You Think.


Dietary Changes

Dietary choices and eating patterns play a central role in acid reflux symptoms—not just what you eat, but how and when you eat. Beyond avoiding known trigger foods, adjusting meal size, timing, and food quality can significantly reduce reflux by improving digestion and lowering pressure against the lower esophageal sphincter (LES).

Eating habits that support digestion

The following practices help optimize gastric motility and digestive signaling:

  • Eat smaller, more frequent meals rather than large portions

  • Chew food thoroughly to reduce digestive workload

  • Eat in a relaxed, parasympathetic state

  • Avoid constant snacking or grazing, which can reduce gastric and intestinal motility

  • Finish your last meal 2–3 hours before bedtime to allow proper gastric emptying

Foods that may help reduce reflux symptoms

Incorporating supportive foods can help calm irritation, improve digestion, and reduce reflux episodes:

  • Fiber-rich foods, such as whole grains and green vegetables, which support motility and gut health (11)

  • Coconut water, which provides electrolytes that support hydration and pH balance

  • Plant-based milks, which are often easier to digest than full-fat cow’s milk

  • Bone broth, which may support gut lining integrity and reduce inflammation

  • Lean proteins, such as chicken, turkey, and certain fish, which are lower in fat and easier to digest

  • Oatmeal, which can help absorb gastric contents and promote satiety

  • Kale, a mineral-rich leafy green that supports digestive balance

  • Ginger, a well-known anti-inflammatory herb traditionally used for digestive discomfort

  • Purple cabbage, which may help regulate digestive pH and reduce irritation

  • Parsley, a traditional medicinal herb used to support stomach function

  • Couscous and brown rice, which provide complex carbohydrates and fiber

  • Fennel, which supports gastric motility and reduces bloating

  • Bananas, which are low in acid and generally well tolerated

  • Melons, which are low-acid fruits and contain magnesium

Supporting stomach acid balance

For some individuals, reflux is associated with low stomach acid, not excess. In these cases, gentle support may be helpful if tolerated:

  • Apple cider vinegar or lemon juice, diluted in warm water before meals or used with protein-containing meals to support digestion

  • Celery juice, consumed between meals, which provides mineral salts that may support healthy hydrochloric acid (HCl) production

Because tolerance varies, these strategies should be personalized and introduced gradually.


These changes work synergistically with gut-focused therapies rather than replacing them.

Natural reflux care is not about “one supplement fixes all.” It’s about restoring coordinated digestive function, supporting tissue healing, and addressing the physiological reasons acid is moving in the wrong direction.


Final Takeaway: Treat the Cause, Not Just the Burn

Acid reflux is rarely a standalone problem. In many cases, it reflects impaired digestion, altered stomach acid signaling, gut dysbiosis, medication effects, and nervous system imbalance—all of which influence how and why stomach contents move upward instead of down.

When care focuses only on suppressing acid, symptoms may temporarily improve, but the underlying dysfunction often persists or worsens over time. This helps explain rebound reflux, nutrient deficiencies, bloating, infections, and broader inflammatory patterns seen with long-term medication use.

A more effective, sustainable approach addresses reflux at its source by restoring coordinated digestive function, supporting healthy lower esophageal sphincter (LES) signaling, identifying gut-level contributors, and regulating stress and autonomic nervous system tone—using targeted nutrition, herbs, and acupuncture appropriately.

If reflux has become chronic, medication-dependent, or intertwined with other digestive or inflammatory symptoms, a personalized, root-cause plan is often where lasting improvement begins through:

Gut Health & Digestive Restoration

Request a free 15-minute consultation with Dr. Martina Sturm at Denver Sports & Holistic Medicine to uncover the root causes of acid reflux and create a personalized plan that supports healthy digestion, gut function, and long-term relief.




Frequently Asked Questions About Acid Reflux and GERD

Is acid reflux caused by too much stomach acid

Not always. While stomach acid is what irritates the esophagus, reflux is often driven by dysfunction of the lower esophageal sphincter (LES), delayed gastric emptying, increased intra-abdominal pressure, dysbiosis, medication effects, and nervous system imbalance. In many cases, reflux is associated with low stomach acid signaling and impaired digestion rather than true acid overproduction.

Can low stomach acid cause reflux symptoms

Low stomach acid is frequently associated with reflux. When acid is insufficient, protein digestion slows, fermentation increases gas and pressure, and LES closure signaling can be impaired. This combination increases the likelihood of stomach contents moving upward into the esophagus.

Do PPIs and H2 blockers make reflux worse over time

They can. Acid-suppressing medications may provide short-term symptom relief, but long-term use can impair digestion, increase dysbiosis risk, and contribute to nutrient deficiencies. Some people also experience rebound symptoms when stopping them. If you are using these medications long term, it is best to review your case with a clinician before making changes.

What are the most common lifestyle triggers for acid reflux

The most common contributors include late-night eating, large meals, tight clothing around the waist, alcohol, smoking, poor sleep, and high stress. These factors influence LES tone, motility, and intra-abdominal pressure, which can increase reflux.

What foods usually worsen acid reflux

Common triggers include fried or greasy foods, chocolate, coffee, alcohol, tomato-based foods, carbonated beverages, citrus, peppermint, spicy foods, and high-sugar meals. Triggers are individual, so a personalized elimination approach is often more effective than a generic list.

Is apple cider vinegar safe for reflux

It depends. For some people with low stomach acid patterns, diluted apple cider vinegar may support digestion and reduce pressure from fermentation. For others, it can worsen burning and irritation. If you try it, start low, dilute well, and stop if symptoms worsen. Avoid if you have ulcers, active gastritis, or severe esophagitis unless your clinician advises otherwise.

Can acupuncture help with GERD and heartburn

For many patients, yes. Acupuncture and Traditional Chinese Medicine approaches may support gastric motility, stress regulation, and digestive coordination. It can be especially helpful when reflux is stress-driven, associated with bloating and pressure, or worsened by nervous system dysregulation.

When should I see a clinician for acid reflux

Seek clinical evaluation if symptoms occur more than twice weekly, if you have difficulty swallowing, unexplained weight loss, persistent nausea or vomiting, black stools, anemia, chest pain, or reflux that persists despite lifestyle changes. These can indicate complications or conditions that require targeted evaluation.





Resources

  1. American College of Gastroenterology – Gastroesophageal Reflux Disease Clinical Guidelines

  2. National Library of Medicine – Pathophysiology of Gastroesophageal Reflux Disease

  3. Wholescripts – Getting Help with GERD: How Integrative Interventions May Support Long-Term Relief from Acid Reflux Symptoms

  4. Mayo Clinic – Gastroesophageal Reflux Disease Symptoms and Causes

  5. National Library of Medicine – Lower Esophageal Sphincter Function and Regulation

  6. Cleveland Clinic – GERD, Heartburn, and Acid Reflux Overview

  7. Mayo Clinic – Barrett’s Esophagus and Long-Term Reflux Complications

  8. Obesity Action Coalition – Obesity as a Risk Factor for Gastroesophageal Reflux Disease

  9. National Library of Medicine – Obesity, Intra-Abdominal Pressure, and GERD

  10. Mayo Clinic – Hiatal Hernia and Its Role in Acid Reflux

  11. Johns Hopkins Medicine – GERD Diagnosis, Treatment, and Prevention

  12. Harvard Health Publishing – Heartburn and Acid Reflux Explained

  13. Live Healthy Chron – Lifestyle Factors That Contribute to Acid Reflux

  14. Addiction Group – Smoking and Its Effects on Digestive Health

  15. Innovative Health Clinic – Tobacco Use, LES Dysfunction, and Reflux

  16. National Library of Medicine – Stress, Gastric Acid Secretion, and Digestive Disorders

  17. SpringerLink – Psychological Stress and Gastrointestinal Motility

  18. National Library of Medicine – Proton Pump Inhibitors and Vitamin and Mineral Deficiencies

  19. PLOS ONE – Acupuncture Therapy for Gastroesophageal Reflux Disease

  20. Journal of the American Society of Nephrology – Proton Pump Inhibitors and Chronic Kidney Disease Risk

  21. National Library of Medicine – Proton Pump Inhibitors and Bone Fracture Risk

  22. JAMA Neurology – Proton Pump Inhibitor Use and Dementia Risk

  23. National Library of Medicine – Hypergastrinemia and Gastric Cancer Risk

  24. National Library of Medicine – Small Intestinal Bacterial Overgrowth Associated With Acid Suppression

  25. National Library of Medicine – Gut Microbiome Alterations With Long-Term PPI Use

  26. Wiley Online Library – Acupuncture and Herbal Medicine in the Treatment of GERD

  27. National Library of Medicine – Traditional Chinese Medicine Approaches to Acid Reflux

  28. American Botanical Council – Deglycyrrhizinated Licorice and Gastric Mucosal Protection

  29. National Library of Medicine – Herbal Formulas for Gastroesophageal Reflux Disease

  30. National Library of Medicine – Zinc Carnosine and Gastric Mucosal Integrity

  31. Natural Medicines – Zinc Carnosine and Upper Gastrointestinal Support

  32. National Library of Medicine – Slippery Elm and Demulcent Effects on the GI Tract

  33. National Library of Medicine – Marshmallow Root and Mucosal Barrier Support

  34. National Library of Medicine – Aloe Vera Polysaccharides and Gastrointestinal Inflammation

  35. National Library of Medicine – L-Glutamine and Intestinal Barrier Function

  36. American Botanical Council – Botanical Therapies for Digestive and Upper GI Disorders

  37. National Library of Medicine – Fennel, Ginger, and Carminative Herbs in Digestive Health

  38. National Library of Medicine – Diet, Fiber Intake, and Gastrointestinal Motility

  39. National Library of Medicine – Circadian Rhythm, Sleep Position, and Nocturnal Acid Reflux