3 Simple Steps to Eliminate Heartburn and Acid Reflux


ARE MILLIONS OF US BORN with a genetic defect that makes us produce too much stomach acid? Do we just have a major evolutionary design flaw that requires us to take powerful acid-blocking drugs to prevent heartburn and reflux?

I believe that the answer to all of these questions is a resounding “no.”

In this week’s blog, I’ll explain why, but more importantly, I will outline a simple 3-step approach that will help you prevent acid reflux and heartburn by treating its underlying causes.

The Truth about Acid-Blocking Medications

At least 10 percent of Americans have episodes of heartburn every day, and 44 percent have symptoms at least once a month. Overall, reflux or GERD (gastroesophageal reflux disease, also known as heartburn) affects a whopping 25 to 35 percent of the US population! (i) As a result, acid-blocking medications are the third top-selling type of drug in America today. Two other drugs to treat reflux, Nexium and Prevacid, are among the world’s best-selling drugs(ii) and account for $5.1 and $3.4 billion in sales annually (in 2006)!

Studies show that people who take acid-blocking medications for the long term can become deficient in vitamin B12

Things have certainly changed since I was in medical school. In those days, GERD wasn’t even considered a serious disease. Instead, people had heartburn or ulcers, but that was pretty much it. When acid-blocking drugs first came on the market, even the pharmaceutical representatives warned us how powerful these drugs were. They told us not to prescribe them any longer than 6 weeks and only for patients with documented ulcers.

Now, these drugs are given like candy to anyone who ate too many hot dogs at a ball game — and one drug, Prilosec, is available without a prescription. Their manufacturers have created the illusion that we can eat whatever we want with no consequences, just by popping a pill. They even have commercials showing a family rushing to stop their father from eating a big sausage with fried onions and peppers — and he tells them not to worry because he took his acid-blocking pill!

I know someone who used to work for the makers of Pepcid, another acid blocker. He told me that when it first became available over the counter, teams of drug company representatives would stand at the gates of county fairs and southern barbeques and hand out free samples.

In reality, acid-blocking drugs are a double-edged sword. Let’s look at some of the recent research on the dangers of these drugs.

What the Research Tells Us about Acid-Blocking Medications

Acid blocking drugs obviously block acid that can cause symptoms of heartburn and reflux. But your body actually needs stomach acid to stay healthy. Stomach acid is necessary to digest protein and food, activate digestive enzymes in your small intestine, keep the bacteria from growing in your small intestine, and help you absorb important nutrients like calcium, magnesium, and vitamin B12.

There’s evidence that taking these medications can prevent you from properly digesting food, cause vitamin and mineral deficiencies, and lead to problems like irritable bowel syndrome, depression, hip fractures, and more.

For example, studies show that people who take acid-blocking medications for the long term can become deficient in vitamin B12,(iii) which can lead to depression, anemia, fatigue, nerve damage, and even dementia, especially in the elderly.

The research also tells us that taking these drugs can cause dangerous overgrowth of bacteria in the intestine called Clostridia, leading to life-threatening infections.(iv) For many more people, low-grade overgrowth of bacteria in the small intestine leads to bloating, gas, abdominal pain, and diarrhea (many of the common “side effects” noted in the warnings for these drugs). This can cause irritable bowel syndrome.

In addition, a recent study in the Journal of the American Medical Association found that chronic use of acid-blocking drugs leads to an increase in the development of osteoporosis and increase in hip fracture because blocking acid prevents the absorption of calcium and other minerals necessary for bone health.(v)

All this is only part of the problem. There have even been some reports that these drugs may increase the risk of certain cancers.

These are serious health concerns, and it’s pretty clear that in this case, the “cure” of acid-blocking drugs is worse than the “disease” of GERD. But that’s of little comfort when you’re suffering from heartburn.

So if drugs are not the answer, what is? We need to find the real causes of reflux and heartburn, get rid of them, and use the right foods, nutrients, and lifestyle therapies to heal the problem.

What Causes GERD?

Fried food, alcohol, caffeine, and soda can all trigger reflux. Spicy, tomato-based or citrus foods may also cause problems for some people. Smoking also increases the risk of reflux. Being overweight and having your belly fat push up on your stomach can prevent it from emptying, triggering reflux. Having a hiatal hernia (where your stomach pushes up through your diaphragm) can also cause trouble and can be diagnosed by x-ray. Eating large meals and eating before bed are two other main reasons for reflux. These are the most obvious causes, and the ones you have probably heard about. However, there are a few more that bear mentioning.

Stress contributes to reflux. Clearly, food is supposed to go down, not up, when you eat. That’s why there are two main valves, or sphincters, that control food going in and out of your stomach — the one at the top (or the lower esophageal sphincter) and one at the bottom (the pyloric valve). When you’re stressed, the valve on the top relaxes and the valve on the bottom tightens up. This may result in food traveling back up your esophagus. Practice active relaxation and you mitigate this problem.

Magnesium deficiency is another cause of reflux because magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to go down.

While controversial, I believe that a common infection can cause not just ulcers but reflux as well. This bug is called Helicobacter pylori and can be identified by a simple test blood or breath test. In my experience with patients, this treating the bacteria can eliminate reflux even if you don’t have an ulcer.

Food sensitivities or allergies can also cause reflux. Common culprits include dairy and gluten-containing foods like wheat, barley, rye, and oats. Plus, overgrowth of bacteria in the small bowel or yeast overgrowth in the gut can cause reflux.

These are all treatable conditions that you don’t need powerful acid blocking drugs to fix.

To properly diagnose the causes of your reflux, you may need to do the following.

  1. Ask your doctor for an H. pylori blood antibody test or breath test.
  2. Consider a test for IgG food allergies and celiac disease.
  3. Get a breath or urine organic acid test to check for small bowel bacterial overgrowth.
  4. If you don’t get better with the suggestions below, consider getting an upper endoscopy or upper GI series x-ray to see if there is anything else wrong.

3 Steps to Permanently Overcoming Heartburn and Acid Reflux

Step 1: Treat the Bugs if You Have Them

  • If you have H. pylori, treat it with triple antibiotic therapy from your doctor.
  • Treat yeast overgrowth with antifungal drugs such as nystatin or Diflucan or herbs such as oregano or caprylic acid.
  • Treat bacterial overgrowth in the small bowel with Xifaxin (see my blog on irritable bowel syndrome).

Step 2: Change Your Diet

  • Try to eliminate dairy and gluten (see www.celiac.com for sources of gluten in the diet).
  • Eliminate alcohol, caffeine, citrus, tomato-based, and spicy foods.
  • Don’t eat within 3 hours before bed.
  • Don’t eat junk food.
  • Avoid processed foods.
  • Eat cooked foods, like fish, chicken, cooked veggies, and rice; avoid raw food for now.
  • Eat smaller, more frequent meals, at least 4 to 5 times a day.

Step 3: Try Some Natural Remedies to Help Soothe the Gut

  • Take 2 to 3 capsules of digestive enzymes with each meal.
  • Re-inoculate the gut with healthy bacteria by using probiotics.
  • Try 75 to 150 mg of zinc carnosine twice a day between meals — this has been extensively studied and is used frequently in Japan.
  • Take 3 to 5 grams of glutamine powder in water twice a day to help heal the gut lining.
  • Chew 2 to 3 chewable tablets of DGL (a form of licorice) 15 minutes before meals.
  • Try 200 to 400 mg of magnesium citrate or glycinate twice a day.

As you can see, there’s no need to suffer from heartburn and reflux — or to take expensive and dangerous acid-blocking drugs. I hope the changes I’ve suggested here will soothe your stomach and have you feeling healthy in no time!

Please leave your thoughts by adding a comment below—but remember, we can’t offer personal medical advice online, so be sure to limit your comments to those about taking back our health!

To your good health,

Mark Hyman, M.D.


(i) Shaheen, N. and D.F. Ransohoff. 2002. Gastroesophageal reflux, Barrett Esophagus, and esophageal cancer. JAMA. 287(15): 1972-1981.

(ii) http://en.wikipedia.org/wiki/List_of_top_selling_drugs

(iii) Ruscin, J.M., Page, R.L., and R.J. Valuck. 2002. Vitamin B(12) deficiency associated with histamine(2)-receptor antagonists and a proton-pump inhibitor. The Annals of Psychopharmacology. 36(5) 812-816.

(iv) Dial, S., Delaney, J.A.C., Barkun, A.N., and S. Suissa. 2005. Use of gastric acid-suppressive agents and the risk of community acquired clostridium difficile-associated disease. JAMA. 294(23): 2989-2995.

(v) Yang, Y., Lewis, J.D., Epstein, S., and David Metz. 2006. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 296(24): 2947-2953.

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21 Responses to 3 Simple Steps to Eliminate Heartburn and Acid Reflux

  1. Sylvia Rupe March 13, 2013 at 10:46 am #

    Have acid reflux on protonix gave me severe beaches migraine and other for over four months. Spent almost four months in bed. Just found out it was the meds.

  2. Maria March 31, 2013 at 3:33 pm #

    Hi Mark,
    Is zinc carnosine safe when your trying to get pregnant?

    • Avatar of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff April 5, 2013 at 1:03 pm #

      Hi Maria,

      Yes, it is likely safe in appropriate doses. However, we cannot provide medical advice in this forum so you will need to work with your local care provider on this!
      If you would like to make an appointment at Dr. Hyman’s UltraWellness Center in Lenox, MA please go to:http://www.ultrawellnesscenter.com/becoming-a-patient/ When you are finished reading through the material you may call the office at After you have reviewed this, please contact our office to make an appointment. By phone, (413) 637-9991; by email, office@ultrawellnesscenter.com

      For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to:http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.

  3. Larry Rogers May 12, 2013 at 10:01 am #

    Aren’t the recommendations totally unrealistic?

    You say the pills are expensive, but they are dirt cheap. Over the counter they can cost less than $4. a month.

    Going gluten free is very expensive relative to the drugs.

    The recommended remedies, such as pro-biotics, are much more expensive than the drugs.

    Telling everyone to Eliminate alcohol, caffeine, citrus, tomato-based, and spicy foods is simplistic and unrealistic. Few can or would do this. Spicy foods have demonstrated little impact as spices introduce much less acid than what the stomach has already and most are not related to reflux. Saying “spicy” is much too broad to be useful.

    You skip exercise and stress reduction as solutions.

    Some of the article is useful, but the recommendations are incomplete, unprioritized, expensive and nearly impossible.

    Eliminating everything will not pinpoint the problem. Selective elimination over time can. In other words, if reducing glutens helps, great. If not THEN try reducing dairy. etc. Not all at once. Not only makes it unrealistic, but not sensible and applicable. Eliminating everything possible is just sily.

    Like the article, needs major work.

    • Carol Jameson September 6, 2013 at 8:48 am #

      Larry can you offer any good suggestions for eliminating acid reflux, or are you one of those people who pooh poohs any and all natural alternatives to taking meds and does not offer any alternatives other than OTC meds that in the long run can cause more problems?

      I know the pills you are referring to that , as you put it, are dirt cheap and uhhh they do not work overtime, in the very beginning they offer some relief, but if you ever took these dirt cheap meds (uhh actually some are over twenty dollars for perhaps 40 or so pills), but you would know they stop working over time, or you need to keep upping the dosages, so then once they stop offering relief those with GERD will eventually need to take prescribed meds which ARE expensive as is surgery.

      Going gluten-free is not all that expensive, you figure fresh fruits and vegetables are gluten-free as are dried beans and gluten free items are not as expensive as you think, plus if you eat less, which Dr Hymen and many other drs recommend how does it cost a lot?

      Again probiotics are not as expensive as you think, a good probiotic packed yogurt is not expensive and no one says to eat three containers a day, eating one a day while you eliminate coffee and sodas evens out as far as cost. Also Kefir is not so expensive. And using natural supplements, while, HELLO, again eliminating the foods that are causing our GERD will save you money in the long run.

      Why, pray tell, do you feel having people eliminating alcohol, caffeine, citrus, tomato based and spicy foods is simplistic and unrealistic? I think if you suffer from acid reflux and know how awful and painful it is you will do anything to stop that gross and irritating to your throat and intestines disorder. Plus you do realize GERD can, over time, lead to esophageal cancer, hmm which is better changing our diet, or keeping on consuming foods that cause your acid reflux and get cancer? And there are plenty of other foods and beverages to consume other than alcohol, caffeine, citrus, tomato based and spicy foods. And uhh Larry drs often tell patients with any kind of digestive issue to stay away from spicy foods, I think people are smart enough to know which spicy foods cause their own acid reflux, it is not too broad a term as that not everyone reacts the same negative way to all spicy foods. I know people who cannot tolerate onions, while can tolerate chilies, go figure, we all know our trigger foods, having a long extensive list is not necessary. Plus everyone has different food allergies, you can’t list every single one you would have pages and pages of foods to eliminate when, like I wrote before, not everyone has the same bad reactions to all foods. Do you, or anyone need Dr Hymen to follow you around all day and take your hand and slap it when you eat foods that you know cause flare ups? People are not stupid, they know which foods they can and cannot consume.

      Dr Hymen mentioned losing weight, uhh you often do exercise to do that. But if you think just stress reduction and exercise alone will magically make acid reflux disappear you ‘re sorely mistaken, those along with diet changes will help. And see you yourself used “broad terms” just what kind of exercises and what kinds of stress reductions are you recommending?

      And Dr Hymen recommended seeing ones dr to get the proper tests one to see if they can pinpoint the causes too. And I have read a lot about H. Pylori, people really should get tested for that, once it is gone their digestive health will return.

      I totally disagree eliminating alcohol, caffeine, tomato based, citrus foods etc at once is impossible, It’s very possible and if it will end the misery of acid reflux, in my book that’s a good thing. Oh and my mother always used to say to drink a glass of water when you have acid reflux and that works too, also do not lay down when experiencing acid reflux..I also believe having backed up feces in your digestive tract creates acid reflux, so if one feels the urge to go they should, promptly, otherwise they are training their body to hold in feces which I think causes a backed up blockage effect and screws up the whole digestion process. .People need to learn how to eliminate as soon as the urge hits and if constipation is an issue they need to find natural ways to go, sometimes something as simple as gently massaging the lower abs in circular motions for minutes at a time helps one go. And another good suggestion is not only eating smaller and more frequent meals, but really chewing your food, turning it to almost liquid before you swallow, this aids in digestion too.

      I feel Dr Hymen offers some very good suggestions and thank God for drs like him who rather than giving people prescriptions for meds who have so many adverse side effects and who knows hat havoc they wreak in the long run, but instead offers natural ways to get rid of the scourge of acid reflux.

    • p July 4, 2014 at 7:05 am #

      If youd ever tried this youd realise why they say this, BECAuSE IT WORKS! Ive gone paleo and never felt better, the price is nothing when you have so ,uch more energy and very rarely get sick.

  4. Shane May 25, 2013 at 10:09 am #

    So Eliminating alcohol, caffeine, citrus, tomato-based, spicy foods, processed foods, and possibly dairy and gluten is a simple solution? No wonder acid blocking meds are so popular!

  5. Teresa August 7, 2013 at 1:40 am #

    My husband took Prilocex for five years. His health has really declined. He is now lactose intolerant and struggles with major digestives issues. His “door” to his stomach does not completely close. His doctor says surgery is the only option, if he doesn’t want to take an acid blocker every day for the rest of his life. He has developed joint problems as well as bruising easily. Do you think your recommendations in your article will help him.

    • Avatar of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff August 16, 2013 at 1:17 pm #

      Dear Teresa,
      Thank you for your interest in Dr. Hyman’s work. While all of Dr. Hyman’s recommendations should be customized to fit an individuals needs, yes, we think your husband might give them a try. For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.

      Inn good health!
      The Nutrition Coaching Team

  6. Heidi November 19, 2013 at 4:14 am #

    I have a 17 year old daughter who suffers chronic acid reflux, we are under a good gastroentaroligist at the moment who is trying to get to the bottom of it (about to have a endoscopy) We have tried oodles of medications and natural remedies. My problem is that the so called recommendations for a low fat diet and what she should and shouldn’t eat isn’t realistic for her as she is a tiny frame with already very low body weight, due to being so unwell so often. It’s a bloody nightmare to be honest and she lives with constant blisters on the back of her throat and feeling unwell for weeks at a time before having periods of feeling okish. As a mother I feel like I’m at my whits end of what more we can do for her, it’s a terrible thing to watch your child going through!! Unfortunately for her she has had reflux ever since being a few weeks old … There has to be a simple “natural” remedy for this!!!

  7. joshua November 28, 2013 at 1:46 am #

    I have been reading a lot about acid reflux and it’s really a pain if you haven’t figured out how to change your diet or have any relief for it. Popping antacids is out of the options for me since I have been really dependent on it.

  8. J.Lewis December 5, 2013 at 6:25 pm #

    Hi There,
    Is there any relation to acid reflux and peri-menopause? I am soon to be 46 and I’m wondering why my GERD suddenly came about?

    • Avatar of Team Hyman
      Team Hyman December 27, 2013 at 2:34 pm #

      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to http://www.functionalmedicine.org/practitioner_search.aspx?id=117 and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
      You can also make an appointment to be a patient at Dr.Hyman’s UltraWellness Center in Lenox, MA. Please go to: http://www.ultrawellnesscenter.com/becoming-a-patient/
      Did you know you can work with Dr. Hyman’s nutritionists virtually? For personalized nutrition coaching, please see: http://store.drhyman.com/Store/List/Coaching-Programs
      In Good Health,
      Dr. Hyman’s Wellness Staff

  9. Jona Cris Peredo May 6, 2014 at 12:57 am #

    Very interesting! thanks for the info and tips.

  10. Anna C May 11, 2014 at 7:21 pm #

    Thanks for this fantastic information – the best page I’ve found on reflux ever. I’ve had a problem for some time – exacerbated during stressful periods – and have this week gone from occasional to daily medication – which is now also failing to do the job. I loathe drugs and always seek a natural solution. Yours is an enlightening article and so glad to be directed towards other preventative and alternative solutions.
    Thanks again.

  11. Mary Sullivan May 11, 2014 at 10:21 pm #

    Lots of information that was helpful. Thank you

  12. Jack Edison May 20, 2014 at 3:20 am #

    Aloe vera juice is also a natural way to treat acid reflux.

  13. Anne June 1, 2014 at 7:29 pm #

    Wouldn’t it have been nice if my Gastroenterolist had shared this information. Unfortunately, many doctors are in the business of finding life-long illnesses to treat – not in the business of healing patients. It’s the nature of this world system where we are taught that we need to make as much money as possible to fulfill ourselves.

  14. Anne June 1, 2014 at 7:31 pm #

    P.S. Thank you for publishing this very valuable information. May you be blessed.

  15. yadira July 12, 2014 at 9:17 pm #

    I got an EGG test done and my Dr. Said I had no kind of bacteria. I do show many symptoms of a yeast overgrowth but I can’t get any doctor to prescribe me difuclan. I don’t understand.

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