The Big Root Causes of Reflux and Heartburn

If you’ve been struggling to find the root cause of reflux and heartburn, this blog post is for you!

Many people put in so much effort to make changes, yet still feel like they’re constantly fighting with their stomach symptoms.

If that’s been your experience, you’re likely only managing symptoms, not addressing the root cause behind those symptoms. Lasting relief comes from understanding what’s actually driving the reflux and heartburn, not just suppressing them.

In this blog, we’re going to break down the six major root causes of reflux and heartburn that I see most often in my clients. Some may sound familiar, and some might surprise you, especially if you feel like you’ve “tried everything” already. 

By the end, you’ll have a clearer understanding of why your symptoms haven’t gone away yet  and what steps can finally move you toward long-term relief.

Root Causes of Reflux and Heartburn

There are six main root causes that tend to drive reflux and heartburn, and most people have a mix of a few.

As you move through each section, take note of the ones that resonate with you.

If you’re not sure where to start, you don’t have to figure it out alone. That’s exactly the type of support I give my clients inside my coaching programs.

You can apply to work with me here!

Let’s work together to identify the root causes of your symptoms and help you feel your best!

H Pylori Infection

The most well-known root cause of reflux and heartburn is an H pylori infection. 

If you’ve followed me for any amount of time, you know this topic is close to my heart. H pylori was a major part of my own healing journey and the journey of so many of my clients.

H pylori is a bacteria that lives in the stomach and can change the stomach environment, which can induce stomach symptoms. 

It increases inflammation, lowers stomach acid, and irritates the stomach lining, all of which create the perfect setup for reflux and heartburn to flare.

However, treating H pylori does not automatically undo the damage it caused.

So if you’ve completed a round of antibiotics or a natural treatment protocol and the infection is gone but you’re still experiencing symptoms, you need to target your support to rebuilding gut resilience, calming inflammation, and restoring normal function.

So if H pylori is one of the root causes of your reflux and heartburn, your first step is to clear the infection. 

But you can’t stop there. After treatment, if your symptoms are still hanging around, you need to work on repairing the damage left behind. Only then will your stomach heal and your symptoms be able to resolve.

Low Stomach Acid (Hypochlorhydria)

The second major root cause of reflux and heartburn is low stomach acid.

When you’re dealing with a burning, sour taste, heartburn, or acid coming up your throat, it feels like the problem is too much acid. 

To make things more confusing, the standard medical approach is to prescribe acid-lowering medications (PPIs).

But in reality, in the majority of my clients, reflux is driven by too little stomach acid, not too much.

 Here’s a quick rundown of how low stomach acid can cause symptoms: 

There’s a valve at the top of your stomach called the lower esophageal sphincter (LES). Its job is to stay tightly closed so stomach contents don’t move upward. 

However, the LES only seals properly when there is enough stomach acid present to trigger that closure reflex. 

When acid levels are low, the LES weakens, and the acid can easily escape upward, creating classic reflux and heartburn symptoms.

Now, low stomach acid isn’t a true standalone root cause. Its a downstream effect of something else causing those acid levels to drop.

But low stomach acid is still something to address in itself! If proper acid levels aren’t restored, it becomes incredibly difficult for reflux and heartburn to fully resolve.

Supporting stomach acid is often a key piece of rebuilding proper digestion and stopping reflux at the source.

Stress and Nervous System Regulation

The third major root cause of reflux and heartburn is stress and nervous system dysregulation. It’s also one of the most overlooked drivers of stomach symptoms.

I’ve worked with many clients who came to me because of reflux and heartburn, had clean endoscopies – no gastritis, no H pylori – and no clear explanation from their GI doctor. 

When that’s the case, the underlying issue is often rooted in the nervous system rather than the stomach itself.

When your body is in a prolonged stress state, whether from emotional stress, grief, overwhelm, or burnout, digestion slows down dramatically. 

This happens due to chronic stress keeping you stuck in a sympathetic mode, or fight-or-flight. On the other hand, the parasympathetic, or rest and digest, state is required for healthy digestion.

If you’ve ever noticed that your reflux or stomach pain flares during stressful seasons, that is not random. 

That is your nervous system communicating with you, prioritizing survival over digestion.

The longer your body stays in that state, the harder it becomes to heal, even if you’re doing the right things.

This is why inside my coaching program, I work extensively with clients on shifting their body back into a parasympathetic state.

If you’re thinking this doesn’t apply to you, yet you’ve done all the protocols, supplements, diets, and you still have symptoms, that’s a sign. 

The truth is: you don’t need a different practitioner or a more aggressive protocol.

You need to work on your stress load, how your body interprets stress, and how to shift your system into a calm, healing state.

Microbiome Imbalance

Another often-overlooked root cause of reflux and heartburn is microbiome imbalance.

While many people immediately think of SIBO or candida, that’s not actually what most of my clients are dealing with. 

The microbiome imbalances that commonly drive reflux are much more subtle. Things like a history of antibiotic use will gradually shift the balance of beneficial bacteria and cause symptoms.

Your microbiome plays an enormous role in digestive health and whole-body function. 

When it’s out of balance, there’s a trickle-down effect that often reaches the stomach. 

Even if you were told “everything looks fine,” microbiome imbalances can still interfere with digestion, nutrient signaling, and the production of key beneficial byproducts your gut needs to function properly. 

Correcting these imbalances rarely requires antimicrobials or expensive gut testing. 

Strategically using probiotics or prebiotics and increasing dietary fiber can make a profound long-term impact on the health and proper function of your microbiome, and therefore the expression of your symptoms. 

These targeted strategies can help restore microbial balance, strengthen digestion, and reduce the symptoms you’ve been fighting.

Under-Eating

Finally, one of the most important root causes of reflux and heartburn, and one of the most common, is under-eating.

Your body simply cannot heal or function optimally if it isn’t receiving enough calories. Food is fuel for your body.

And when you’re not eating enough, your body can’t tell the difference between you skipping meals because you feel awful and you living through an actual famine.

Due to this, it responds in the only way it knows: it conserves energy, shifts into survival mode, and downregulates digestion. 

Everything slows down, including stomach emptying, enzyme production, and the overall digestive process. When digestion slows, reflux and heartburn almost always worsen.

This is why when I work with clients, we look at how much they’re eating compared to what they need to function well. From there, we work on gradually increasing calories using easy-to-digest, reflux-friendly foods so their body has the energy required not only to function properly, but to heal.

If you’ve addressed the other root causes but still have lingering symptoms, take a closer look at your calorie intake. Under-eating may be the missing piece keeping you from feeling better.

And, I don’t want to gloss over the fact that when you are dealing with symptoms like reflux and heartburn, eating enough can be a challenge.

You don’t often feel well, you get full easily, and even just looking at food can make you nauseous.

If that is the case for you, getting support from a practitioner who has experience helping people be able to add more calories to their day without worsening symptoms (like me!) can be a great next step.

The Bottom Line

There are so many underlying causes of reflux and heartburn. And each person is going to have a different combination of triggers and factors impacting their digestion and causing symptoms.

And if you’ve been on this journey for a while now, I’m sure you’ve worked to address at least a few potential underlying issues keeping your symptoms hanging around.

In my practice, the most common underlying causes of reflux and heartburn are:

• H pylori infection
• Low stomach acid (hypochlorhydria)
• Stress and nervous system dysregulation
• Stomach irritation and gastritis
• Microbiome imbalance
• Under-eating

My hope is that you can look at this list and identify which areas might be contributing to your symptoms that you may not have looked at previously.

And if you’re feeling overwhelmed or unsure where to start, you’re not alone!

Ready for Support?

If you want a deeper breakdown of how to actually address these root causes in a step-by-step, realistic way, I go through all of this inside my free, on-demand training.

In it, I break down my Stomach Reset Method, which is the exact approach I use with clients to help them calm their symptoms, rebuild their stomach health, and get lasting relief.

If you’re ready to move beyond symptom management and understand how to heal what’s driving your reflux, I’d love for you to check out this free on-demand training:

How to Heal Your Reflux, Heartburn, and Stomach Pain Without Restrictive Diets, Expensive Supplements, or Unwanted Medications.

Inside this short training, you’ll discover:

• Why common treatments often make reflux worse in the long run
• The 3-step process I use with my clients to calm symptoms and restore proper digestion
• How to start building resilience in your gut so symptoms don’t keep coming back

Save your spot in the free training here and take the first step toward lasting relief.

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