10 GERD Mysteries your Doctor never told you about

By Stu Leo︱Published October 29, 2017

Gastroesophageal reflux is a mysterious disease. Since the 80s, GERD has increased dramatically in the Western World. What causes the disease and how can we prevent it? We’re still trying to figure that out.

Conventional medicine has come up with ways to treat the symptoms of GERD/LPR, but ultimately fails to treat the underlying condition.

The fact is we still know little about what causes GERD, and believe it or not, that actually gives me hope that there is a cure out there. We just need to keep digging.

In this article, I will discuss 10 thought-provoking questions about GERD. Hopefully, these questions will highlight the areas we need to research in order to find a cure.

1. A Western Disease?

Why is acid reflux so prevalent in the Western world? (1) Diet seems to play a big role. Countries such as Japan and Singapore have reported very low rates of acid reflux whereas countries that have adopted a Western diet have had an uprise in both acid reflux and Western diseases. (2) (3) (4) I think that’s significant.

Several studies have confirmed the connection between diet and acid reflux. But currently, GERD/LPR patients are only told what NOT to eat.

In my opinion, it is just as important to tell GERD patients what they SHOULD put in their bodies to prevent the risk of chronic diseases like GERD. 

2. Acid Reflux is Normal

I hardly hear anyone talk about this, but did you know that acid reflux is actually considered a normal physiological process that occurs several times every day in everyone—even in healthy individuals? (5) (6)

Reflux is only considered a disease if it causes troublesome symptoms or injury to the mucosal membrane within the esophagus, larynx, or respiratory tract. (7)

So why don’t healthy people experience symptoms even though they get reflux?

What are they doing differently? Can we teach GERD patients to do the same? It doesn’t seem like reflux alone is the main issue.

3. How does an internal muscle even “break”?

Typically, healthy human organs don’t just fail out of the blue. Your heart doesn’t just stop working all of a sudden unless its ventricles fail to pump blood. Your lungs don’t suddenly stop working unless they get injured. And the brain, unless it is traumatized, doesn’t just shut down immediately. Diseases tend to progress over time. And there’s almost always a cause.

Yet the majority of the research we have right now states that GERD/LPR is caused by a “damaged” lower esophageal sphincter (LES). The LES is a muscle at the junction of the esophagus and stomach that opens and closes throughout the day when we burp.

The theory is that the LES all of a sudden becomes “damaged,” and fails. We have no idea why. It just stops working. No reason, cause, or explanation. There are only theories.

To me, it doesn’t make sense that an LES that has worked perfectly fine just a few months ago can all of a sudden fail for no reason.

Research has been lacking in this area. We need to find out more.

Can the LES be controlled or trained to close? What exactly causes the LES to stop working?

We don’t really know.

4. If the cause of GERD/LPR is really mechanical then why do some people who get surgery still experience reflux symptoms? Why doesn’t acid reflux surgery work for all people?

Acid reflux surgery such as the Nissen Fundoplication focuses on tightening the LES because conventional medicine believes the problem is mechanical.

A loose LES causes GERD symptoms.

But the fact that many people still experience GERD symptoms after getting reflux surgery indicates that in many cases, the underlying cause of GERD isn’t mechanic.

More troubling is that some people still take PPI medication after getting surgery and even then, still experience GERD symptoms.

I think it’s great that many people who have gotten a Nissen Fundoplication are symptom-free for years.

But what about those who got surgery and are still suffering? What does that tell us about GERD?

Clearly, some types of reflux are not caused by mechanical issues.

Why the difference? We do not know. 

5. What is the connection between GERD and Stress?

I’ve noticed that many people who suffer from GERD/LPR, especially those who have symptoms like hoarseness usually have a lot of stress in their lives.

Oftentimes, one or more stressful events in their life can lead to a sudden onset of GERD symptoms.

Does stress affect the lower esophageal sphincter? How exactly does it contribute to acid reflux attacks? And how come the doctors I’ve seen never told me about the influence of stress? More research is needed in this area.

6. If GERD is incurable, why have people healed from it?

If GERD is incurable how come so many people have reported cures? Hop on Google and take a look at health forums and Facebook groups. These people are everywhere.

To me, it just doesn’t add up. So many people have had obvious signs of acid reflux and yet their symptoms significantly improved or resolved completely with no surgery and no PPIs. Why is that? Maybe they never had GERD/LPR in the first place? Possible, but unlikely.

So the natural question is, how is it possible they’re able to recover if the cause of acid reflux is due to lower esophageal sphincter failure? Perhaps the LES can heal?

7. Does Indigestion cause Reflux?

Is there a relationship between digestion and acid reflux? It seems like it. Many people have reported getting better after taking digestive supplements like enzymes, probiotics, and HCL.

The digestion component seems to go against the theory that GERD is caused by a weak or “broken” LES.

Does indigestion affect the LES? Or does it just mimic the symptoms of a weak LES? These questions aren’t covered much in the medical literature.

8. Why do people who fast still get acid reflux?

It doesn’t seem logical. How can a person who doesn’t eat anything get acid reflux?

We know when a person fasts their stomach contents tend to be quite acidic, but still, after fasting for a while the body should adapt. Plus, there’s no pressure on the stomach at all. How does it come back up? 

Does the strength of stomach acid cause the LES to fail? We don’t have much research on this.

9. Acid reflux from just a sip of water?

Can you get acid reflux just by drinking water? Apparently, yes.

Many GERD sufferers, especially those with LPR have trouble keeping even water down. In these cases, acid reflux seems to be caused by something other than indigestion.

Could a sensitive stomach or some kind of food intolerance cause this issue?

Most people who have trouble keeping down water haven’t always been that way. The symptoms may develop into a chronic issue over time.

10. Many cases of Barrett’s Esophagus and Cancer are not associated with GERD?

The most feared consequence of GERD is Barrett’s Esophagus morphing into esophageal cancer.

Chronic GERD sufferers are usually quite worried about these conditions but the truth is the risk of developing Barrett’s or cancer is quite low.

The majority of people with Barrett’s Esophagus lie undetected and have no symptoms of GERD (8)

As for esophageal cancer, more than 40% of esophageal cancer patients have no history of typical GERD symptoms. (9) Most people aren’t diagnosed until the disease is at an advanced stage.

So clearly, there are significant factors other than GERD that influence your chances of developing Barrett’s Esophagus or esophageal adenocarcinoma. 

Final Thoughts

The fact that there is still so much we don’t know about GERD gives me hope. 

The theory right now is that a “broken” LES causes GERD, but what does that even mean? What exactly causes that failure?

I believe the key to unlocking the GERD mystery lies in that question.