GERD: Why Your Reflux Keeps Coming Back
Many people assume GERD (gastroesophageal reflux disease) is simply caused by having too much stomach acid. While acid plays a role, the real story is often more complex. Factors such as eating habits, meal timing, body weight, certain foods and beverages, and the function of the lower esophageal sphincter—the valve that separates the esophagus from the stomach—can all contribute to recurring symptoms.
In my years working in gastroenterology, I've seen how frustrating reflux can be; especially when patients spend years treating symptoms without understanding what's driving them.
Understanding these underlying factors can help you manage reflux more effectively and reduce the frequency of flare-ups.
In this issue, we'll explore some common triggers of GERD and practical lifestyle habits that may help keep symptoms under control.
What's actually happening
The lower esophageal sphincter (LES) is a ring of muscle that sits between your esophagus and stomach. Its job is to keep stomach contents where they belong. When the LES becomes weak or stops functioning properly, stomach contents can move back up into the esophagus — causing the heartburn and regurgitation that most people recognize as GERD.
This is why acid-reducing medications don't always solve the problem completely. They can quiet the burn, but they don't correct the underlying mechanical issue. Factors like meal timing, large portion sizes, excess abdominal pressure, delayed stomach emptying, or a hiatal hernia may still be contributing.
Common Symptoms of GERD
Heartburn (a burning feeling in the chest)
Regurgitation (food, liquid, or acid coming back up)
Chest discomfort
Chronic cough
Frequent throat clearing
Hoarseness
While heartburn and regurgitation are the most common symptoms, GERD can sometimes present in less obvious ways
Hiatal Hernia
A note on Hiatal Hernias
A hiatal hernia occurs when part of the stomach pushes upward through the diaphragm. Normally, the diaphragm and LES work together to prevent reflux. When that support system is disrupted, stomach contents have an easier path back up.
Not everyone with a hiatal hernia has GERD — and not everyone with GERD has a hiatal hernia. But it's worth knowing about, because it can make symptoms harder to manage with lifestyle changes alone.
Simple Habits That Can Help
Avoid lying down for at least 2 hours after eating.
Eat smaller meals rather than large portions.
Limit trigger foods and beverages — common ones include alcohol, coffee, chocolate, spicy foods, tomato-based products, citrus, peppermint, and high-fat meals.
Maintain a healthy weight; excess abdominal pressure can worsen reflux.
Avoid heavy meals close to bedtime.
If nighttime reflux is a problem, elevate the head of your bed by 6–8 inches. Extra pillows are usually less effective than raising the bed itself.
The bigger picture
GERD is not always about producing less acid. Often, it's about improving the conditions that allow reflux to occur in the first place.
Small changes in eating habits, meal timing, and overall digestive health can make a meaningful difference.
Understanding the why behind your symptoms is usually the first step toward feeling better.
Know someone dealing with reflux? Forward this to them.
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To your health,
Heidy Dorta, FNP-C
Founder | Ondi Health & Wellness
Helping you understand gut health, hydration, and wellness — one simple step at a time.
Disclaimer:
This newsletter is for educational and informational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. The information provided should not be considered medical advice and should not replace consultation with a qualified healthcare professional. Always consult your healthcare provider regarding persistent digestive symptoms or before making significant changes to your health routine.