Your Reflux Questions Answered: Ask a Nutritional Therapist...
Reflux is one of the symptoms clients bring up most often, quite often as an afterthought - rarely the headline complaint, but often one of the most disruptive, and for some, if left unaddressed, progressive. And it's so common, and so easily managed with Rennies or Gaviscon, that it's become almost normalised.
Here are some of the common questions answered...
"Is it normal to get heartburn this often?"
Common, yes. Normal, not really. Reflux affects a huge number of people, and OTC medication prices reflect that - UK supermarket prices for Gaviscon Advance have risen by roughly 25% since early 2022, partly driven by how many of us reach for it daily.
Frequent reflux - technically GORD (Gastro-Oesophageal Reflux Disease) when it becomes a regular pattern - is a sign, not simply something you have to live with. The question worth asking isn't "how do I stop this for tonight?" but "what's actually going on?"
"What's physically happening when I get that burning feeling?"
Between your stomach and oesophagus sits a valve called the lower oesophageal sphincter (LOS): its role is to let food down, then stay shut. When it doesn't, stomach acid travels back up - and that's the burn.
A useful rule of thumb: burning above the bottom of your breastbone is usually reflux; discomfort below that is more likely indigestion.
"I don't always get heartburn - could it still be reflux?"
Yes. Reflux can show up as bloating, nausea, excessive burping, or chest tightness, with little or no burning at all, often flaring after heavy meals, bending forward, or lying down too soon after eating. Disrupted sleep is often a knock-on effect of night time reflux, even without noticing the burn.
"I've heard of 'silent reflux' - what is that?"
Silent reflux is reflux without the obvious heartburn; stomach contents travel up far enough to irritate the throat and voice box. It can show up as a chronic sore throat, throat clearing, post-nasal drip, nasal stuffiness, morning hoarseness, or a nagging dry cough, and is easy to mistake for allergies.
"Does this have anything to do with my gallbladder?"
It can, particularly if what you're experiencing is bile reflux rather than typical acid reflux. Bile, made in the liver to help digest fats, normally moves down through the gut, but can flow back into the stomach and sometimes the oesophagus instead. It has its own pattern: upper-abdominal burning, nausea, a bitter taste, and sometimes vomiting bile. Antacids and PPIs generally don't touch it.
The gallbladder stores and releases bile with meals; without it (after removal), bile trickles into the gut continuously, making it more susceptible to travelling back up. Even with the gallbladder intact, sluggish bile flow from hormone imbalance, poor diet, or poor gut motility means fats aren't broken down efficiently. Undigested fat can ferment and raise abdominal pressure, straining the LOS and feeding reflux more broadly. If symptoms persist, it is worth having a conversation with your GP.
"Doesn't reflux just mean too much stomach acid?"
Not necessarily - and this is usually the most surprising answer in clinic. Low stomach acid is a common, under-recognised cause: without enough acid to break food down, it ferments instead, creating gas and pressure that pushes upward through the LOS.
"Why do I get it so much worse than my partner, on the same meals?"
Because reflux is rarely caused by one single thing, common contributors include:
• Stress, affecting acid and enzyme production.
• A weakened LOS, from pressure, certain foods, or hormonal shifts.
• Diet, particularly sugar, fried food, alcohol, and processed meals.
• Gut imbalances, including SIBO (small intestinal bacterial overgrowth). Have a read of our Blog all about SIBO for more information.
• Daily habits, eating on the go, lying down soon after meals, smoking, excess weight.
• Long-term medication use, regular antacids, NSAIDs, and certain blood pressure, antidepressant, or osteoporosis medications.
• Physical factors, such as a hiatus hernia, pregnancy, ulcers, or H. pylori infection.
Working out which apply to you is far more effective than treating it as a food-alone problem, reacting to certain foods is often a sign one of these drivers is at play, not the cause itself.
"My GP put me on omeprazole - is that a problem?"
PPIs like omeprazole and lansoprazole are genuinely effective, and often necessary, especially short-term. Current NHS guidance is that they're prescribed for the shortest time and lowest effective dose needed, with regular review. Longer-term use is sometimes essential - alongside long-term NSAID use, or for conditions like Barrett's oesophagus or severe oesophagitis.
Long-term use can carry risks, including reduced absorption of nutrients like B12, magnesium, calcium, and iron, and a higher chance of less-friendly bacteria establishing in the gut, so the focus is on supporting nutrient status, gut bacteria, and how you eat alongside it.
Rebound acid hypersecretion is where the stomach temporarily overproduces acid after stopping, and it doesn't require years of use. Research shows it can occur after as little as 8 weeks, and is easily mistaken for reflux returning or worsening, when it may just be a temporary rebound settling down. A good reminder to come off a PPI gradually and with GP guidance.
Nutritional support can help ease symptoms like rebound heartburn, bloating, and fatigue during this process.
"Do I need to cut out all my trigger foods forever?"
Not usually, and not all at once. Common aggravators include coffee, alcohol, fizzy drinks, tomatoes, vinegar, spicy or fried food, ultra-processed meals, and full-fat dairy for some. Triggers are individual, and elimination and reintroduction are far more useful than cutting everything based on guesswork.
"Does it matter how I eat, not just what?"
Genuinely, yes. Around 20–30% of your stomach acid is released before your first bite, during the cephalic phase of digestion - triggered by seeing and smelling food. Eating at your desk or scrolling while you chew skips these signals, so digestion starts on the back foot. Slowing down gives your body the head start it needs.
"What can I do starting tonight?"
• Leave 2–3 hours between eating and lying down
• Prop your head up slightly overnight
• Put your cutlery down between bites and eat without screens
• Sip water steadily through the day
• Take a short walk after meals
• Build in a few minutes of calm before eating
"When should I actually get help, rather than just managing it?"
If reflux has become a weekly (or nightly) occurrence, if you're avoiding foods you used to enjoy, or you've relied on the same medication for a long time without asking why - that's a good moment to explore what's really driving it. Reflux is your body communicating, not something to push through.
Ready to work out what's really going on?
If reflux has been part of your routine for a while - heartburn, silent reflux, bile reflux, or you're not sure which - you don't have to work it out alone.
I'm an accredited Reflux Practitioner, trained through Digestion With Confidence under pharmacist and nutritional therapist Debbie Grayson, a leading UK expert in reflux and PPI management. In practice, that means I can look closely at what's driving your symptoms, and where appropriate, support you safely alongside your GP if you're considering reducing or coming off a PPI.
If you'd like support getting to the bottom of your reflux, book in for a Free Clarity Call and take the first step towards lasting relief.
By Holly Rothschild (Registered Nutritional Therapist).
Holly works alongside our holistic team of Physical & Mental Health Therapists (Chiropractic, Massage, Counselling, Reflexology, CranioSacral Therapy, Yoga/Pilates & more) in our Maidstone Clinics, doing online Nutrition Consultations, to help co-manage our patients with conditions such as this :)
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