GERD Isn’t Just About Acid
A Functional Medicine Perspective on Chronic Heartburn
Dr. Tracy Trancihitella, ND | Sunrise Functional Medicine
Heartburn has quietly become one of the most common digestive complaints worldwide. In fact, gastroesophageal reflux disease—better known as GERD—has increased dramatically over the past few decades, affecting hundreds of millions of people globally. For many, it shows up as a familiar burning in the chest, regurgitation after meals, or that uncomfortable lump-in-the-throat sensation that never quite goes away.
What’s often surprising is how many people are managing these symptoms long-term with acid-suppressing medications—sometimes for years—without ever being offered a deeper look at why the reflux started in the first place. At Sunrise Functional Medicine, GERD is viewed not as a simple excess-acid problem, but as a signal that something in the digestive system is out of balance.
GERD Symptoms Go Beyond Heartburn
While heartburn and regurgitation are the most recognizable symptoms, GERD can look very different from person to person. Many people experience bloating, frequent burping, nausea, difficulty swallowing, or upper abdominal discomfort. Others notice chronic cough, hoarseness, worsening asthma, or sleep disturbances—symptoms that don’t always immediately point back to digestion. GERD symptoms also tend to worsen after meals or when lying down, which can disrupt sleep and quality of life over time.
The Role of the Lower Esophageal Sphincter
To understand GERD, it helps to understand how digestion is supposed to work. The lower esophageal sphincter (LES) is a muscular valve that opens to let food into the stomach and then closes tightly to keep stomach contents where they belong.
When that valve doesn’t close properly, stomach contents—including acid—can move back up into the esophagus, irritating sensitive tissues that aren’t designed to handle it. This dysfunction can be influenced by many factors, including pressure in the abdomen, delayed stomach emptying, nerve signaling issues, inflammation, and even stress.
Why Acid Suppressors Aren’t the Whole Story
Proton pump inhibitors (PPIs) and H2 blockers are commonly prescribed for GERD, and they can be helpful—especially in the short term or in more severe cases. These medications are effective at reducing acid exposure and allowing irritated tissues to heal. However, many people remain on these drugs indefinitely. Long-term use has been associated in research with increased risks such as nutrient malabsorption, bone fractures, kidney disease, infections, and changes in the gut microbiome. This doesn’t mean these medications are “bad,” but it does raise an important question: is suppressing acid forever really the best solution?
From a functional medicine perspective, medications can be a tool—but they’re rarely the entire plan.
A Functional Medicine View of GERD
Rather than focusing only on symptom suppression, functional medicine looks at GERD as a condition influenced by multiple interconnected systems. These often include:
- Gut microbiome imbalance (dysbiosis)
- Delayed stomach emptying
- Inflammation of the digestive lining
- Hormonal influences
- Stress and nervous system regulation
- Lifestyle and dietary patterns
Stress, in particular, plays a bigger role than many people realize. Research shows strong connections between GERD, anxiety, and depression—highlighting the importance of the gut-brain relationship. This is why treatment plans at Sunrise Functional Medicine are personalized and comprehensive, rather than one-size-fits-all.
Lifestyle Shifts That Make a Real Difference
For many patients, small but targeted lifestyle changes can significantly reduce symptoms and improve long-term outcomes. These may include:
- Avoiding meals within two to three hours of bedtime
- Elevating the head of the bed to reduce nighttime reflux
- Identifying personal trigger foods (often coffee, alcohol, chocolate, spicy or acidic foods, and high-fat meals)
- Eating smaller, more frequent meals
- Supporting healthy weight if appropriate
- Quitting smoking
Mindfulness practices, breathing exercises, and stress reduction strategies have also been shown to decrease reflux severity—reinforcing that digestion doesn’t happen in isolation from the nervous system. Regular physical activity has likewise been associated with a lower risk of developing GERD, making movement an important part of digestive health.
Supporting the Gut—Not Just Blocking Acid
One of the most important insights from functional medicine is that low stomach acid, not excess acid, can sometimes contribute to reflux symptoms. In these cases, food may sit in the stomach too long, increasing pressure on the LES and encouraging reflux. Depending on the individual, care plans may include strategies to:
- Address gut dysbiosis, including bacterial overgrowth in the small or large intestine
- Support digestion, sometimes with enzymes or targeted stomach acid support
- Soothe and protect irritated tissues, using nutrients and botanicals that support mucosal healing
- Rebalance the gut-brain connection, supporting sleep, stress resilience, and circadian rhythm
These approaches are always individualized and carefully supervised, especially for patients currently using acid-suppressing medications.
Why Testing Matters
GERD symptoms don’t always tell the whole story. Comprehensive gut testing can provide valuable insight into microbial balance, inflammation, digestive function, and bacterial overgrowth—factors that often contribute to chronic reflux. Tools such as comprehensive stool testing and SIBO breath testing may be used to guide care. This allows treatment plans to be targeted, efficient, and personalized rather than based on guesswork.
The Risks of Ignoring GERD
Left untreated—or managed only at the symptom level—GERD can lead to more serious complications over time. Chronic acid exposure can damage the esophagus, increasing the risk of strictures, ulcers, Barrett’s esophagus, and even esophageal cancer. Extra-esophageal effects may include dental erosion, chronic respiratory symptoms, poor sleep, and worsening anxiety or depression. This is why addressing GERD early, thoughtfully, and comprehensively matters.
A More Sustainable Path Forward
GERD doesn’t have to be a lifelong sentence of medication dependence. With the right support, many people are able to reduce symptoms, improve digestive function, and—when appropriate—safely transition away from long-term acid suppression. Dr. Tracy Tranchitella, ND, works collaboratively with patients to uncover root causes, support gut health, and create realistic, sustainable care plans that align with each person’s health history and goals.
If chronic heartburn has become “normal” in your life, it may be time to look deeper. GERD is often the body’s way of asking for attention—functional medicine helps translate that message into meaningful healing. Learn more and request a consultation >>