The Case:  Candace is 39 and has been dealing with acid reflux for years. She was diagnosed with GERD and prescribed acid lowering medication but when it stopped working she switched to probiotics and digestive enzymes.  These helped a little but she was still suffering and needed to find the root cause. Gastroesophageal reflux disease (GERD) and acid reflux diagnoses have been increasing dramatically for the past 20 years. So much so that it is now considered a very common disorder with an estimated 20-30% of the Western population experiencing it. However, many people who suffer from it are prescribed acid-blocking medications like Prevacid, Omiprezole and Nexium however, these options come with their own concerns and cautions. Few patients are encouraged to look for the cause of their issue, but when Candace came to see me, I knew that was exactly what we needed to do.  The Investigation Candace experienced some relief by following a strict course of probiotics and digestive enzymes however it didn’t completely relieve her symptoms. I knew that there had to be something that was continuing to cause inflammation and an imbalance in the gut.  Lisa Pomeroy is a naturopathic doctor and functional medicine consultant. She coaches and offers online training through the Pomeroy Institute for Functional Nutrition. She is also a clinical consultant for two of the top functional laboratories where she guides the experts in interpreting functional lab test reports and developing effective nutritional protocols.  Causes of GERD and Acid Reflux The increase in occurrences of GERD and acid reflux may be attributed to the increase in gastrointestinal infections. Many of these go undetected and over time cause acid reflux. Lisa also thinks that our shifting diet (including refined processed foods and non-organic foods) is also a culprit in the increased rate of GERD diagnosis. And, our eating habits can also contribute to the development of GERD. Common GI Tract Infections There are many potential infections that can affect the stomach but the most common is Helicobacter pylori (aka H pylori). This infection of the upper digestive tract can cause symptoms of stomach pain (especially within an hour or so of eating), feelings of hunger when there shouldn’t be, and acid reflux. Food is usually digested within 90 minutes of eating so feeling like food is ‘sitting like a rock’ in the stomach 90-minutes or more after eating can also be a clue that H Pylori might be the present. An aversion to protein may also be an indicator.  Symptoms of H Pylori In addition to the above mentioned gut issues, H Pylori can also manifest as sleep issues, fatigue, malnutrition (not absorbing nutrients), or skin issues such as rosacea, acne, psoriasis or eczema. Hashimoto’s and other autoimmune issues can be triggered by H Pylori. Mental health issues like anxiety or depression may also be a result, or exacerbated by H Pylori.  Too Little or Too Much Stomach Acid A lot of people think that acid reflux is because there is too much acid in the stomach, however, it can also be caused by not enough acid in the stomach. Acid is required to break food down so when there is too little, it can cause an imbalance of digestive enzymes and other digestive issues. Acid is also what helps keep food in the stomach by triggering the lower esophageal sphincter or L.E.S. When there is not enough acid, this can open up and allow food and stomach bile to travel back up into the throat. Testing for H Pylori The conventional test for H Pylori is a serum antibody test however Lisa does not like to use this test because there are a lot of false negatives and there is no way to know if the infection is new or old. A breath test is also common in conventional medicine but this can also deliver a false negative. Additionally, traditional doctors will do an endoscopy and biopsy which may or may not find the infection. Lisa’s preferred method of testing for H Pylori is a stool test (and the