Digestive Health / GERD & Reflux

GERD & Acid Reflux Treatment in San Diego, CA — Natural Approach

GERD and acid reflux treatment in San Diego — root-cause approach beyond acid blockers. For chronic reflux, stomach burning, and GERD without PPIs. By Dr. Joseph Dubroff, N.D.

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GERD acid reflux natural treatment San Diego
The Counterintuitive Truth

Your Acid Isn't the Problem. It Might Be the Solution.

If you've ever had heartburn, your doctor probably told you that you have "too much stomach acid" and prescribed something to suppress it — a proton pump inhibitor (Prilosec, Nexium, Prevacid) or an H2 blocker (Pepcid, Zantac). The medications work in the short term because they reduce acid, and acid is what's burning when reflux occurs. Problem solved, right?

Except that for a substantial portion of GERD patients, the underlying cause is actually low stomach acid, not high. The "too much acid" framing made intuitive sense in the 1980s when PPIs were first marketed — but research has consistently shown that stomach acid production tends to decrease with age, not increase. By the time most patients develop chronic reflux, they're often producing too little acid, not too much.

"The medication makes the symptom go away, but it's also driving the underlying problem deeper. Patients end up on PPIs for years — and the longer they're on them, the worse the underlying gut function gets."

Here's the mechanism. Your stomach is supposed to be highly acidic — that's how it sterilizes incoming food, activates digestive enzymes, and signals the lower esophageal sphincter to close tightly. When acid is low, the sphincter doesn't close properly, food sits in the stomach undigested, fermentation produces gas, gas pushes stomach contents — including whatever acid is present — upward into the esophagus. The result feels like "too much acid" because acid is what's coming up. But the upstream problem was too little acid to begin with.

Suppressing acid further with PPIs makes the immediate burning sensation go away, but it deepens the underlying dysfunction. Over time, patients develop SIBO (because acid no longer sterilizes incoming bacteria), nutrient deficiencies (B12, magnesium, iron — all dependent on stomach acid for absorption), increased fracture risk, increased infection risk, and rebound hyperacidity when trying to discontinue the medication.

Long-Term PPI Concerns

What the Black Box Warning Doesn't Tell You.

PPIs were originally approved for short-term use — typically 8 weeks. Most patients today have been on them for years or decades. The research on long-term use is concerning enough that the FDA has issued multiple safety communications.

— Concern 01

Nutrient Deficiencies

Stomach acid is required to absorb B12, magnesium, iron, calcium, and zinc. Long-term acid suppression produces measurable deficiencies in all of these. B12 deficiency in particular can cause neurological symptoms that often get attributed to "aging" but are actually iatrogenic.

— Concern 02

SIBO & Microbiome Dysbiosis

Stomach acid is your first defense against incoming bacteria. Suppressing it for years allows bacterial overgrowth in the small intestine and shifts the broader microbiome. PPIs are one of the most common drivers of SIBO that we see clinically.

— Concern 03

Increased Fracture Risk

FDA-documented increased risk of hip, wrist, and spine fractures with long-term PPI use, particularly in patients over 50. Driven by reduced calcium absorption and effects on bone metabolism.

— Concern 04

Rebound Hyperacidity

Trying to discontinue PPIs often produces severe rebound reflux symptoms — sometimes worse than the original problem. The body up-regulates acid-producing cells while on suppression, then they all fire when the medication stops. This is why patients can feel "stuck" on PPIs.

The Real Approach

What Actually Resolves GERD.

Dr. Dubroff's approach to GERD is built around addressing the underlying drivers — not just suppressing the symptom. The protocol varies based on testing and what's actually happening for you, but the components typically include:

  • Stomach Acid AssessmentIf your reflux is driven by low acid (which most chronic GERD is), the answer is supporting acid production — not suppressing it further. Sometimes targeted HCl supplementation, often combined with stomach lining support.
  • SIBO TestingIf SIBO is present, addressing it is often the single most impactful intervention. Many "chronic GERD" patients see reflux resolve entirely after SIBO eradication.
  • Lower Esophageal Sphincter SupportSpecific nutrients, dietary changes, and lifestyle modifications that improve sphincter function — including identifying foods and patterns that weaken it.
  • Gut Lining RepairIf the esophagus and stomach lining are inflamed from chronic reflux, repair protocols including L-glutamine, zinc carnosine, slippery elm, DGL, and sometimes BPC-157 to support tissue healing.
  • Structured PPI TaperFor patients currently on PPIs, a gradual taper protocol that addresses rebound hyperacidity while the underlying drivers are corrected. This is essential — abruptly stopping PPIs often produces severe symptoms.
  • Dietary & Lifestyle AdjustmentsMeal timing, head-of-bed elevation, identifying trigger foods, alcohol moderation, weight management when relevant, and stress management — because all of these affect reflux directly.
Common Questions

GERD & Acid Reflux FAQs

If my acid is low, why does it burn?+
Even small amounts of stomach acid burn when they reach the esophagus — because the esophagus isn't built for acid exposure. The amount of acid doesn't have to be high; the location is what matters. When the lower esophageal sphincter doesn't close properly (often because acid was too low to signal it correctly, or because pressure from undigested food and gas is pushing upward), even reduced acid produces burning.
Should I just stop my PPI?+
No — not abruptly. Rebound hyperacidity is a real phenomenon and often produces severe symptoms that send patients right back to the medication. Discontinuing PPIs successfully requires a structured taper protocol alongside addressing the underlying drivers. Dr. Dubroff has helped many patients successfully come off long-term PPI use — but it requires a plan.
How can I tell if my acid is high or low?+
There's a clinical assessment (Heidelberg pH testing, baking soda challenge as a rough indicator), symptom pattern (low acid tends to feel like bloating and pressure after meals; truly high acid is less common in chronic GERD), age (acid production declines with age), and response to a trial. Dr. Dubroff will walk you through the assessment during the consultation.
Are there exceptions where PPIs are actually appropriate?+
Yes — short-term use for acute peptic ulcer disease, severe erosive esophagitis, Zollinger-Ellison syndrome, or after specific procedures. The concern is with long-term, chronic use of PPIs for symptomatic GERD without identifying the underlying cause. Dr. Dubroff isn't anti-PPI categorically — he's against using them as a permanent substitute for actually understanding what's going on.
What about hiatal hernia?+
Hiatal hernia is a real structural cause of reflux and is often missed on standard workups. If structural assessment shows a hiatal hernia is contributing, the treatment approach changes — sometimes including specific manual therapy techniques to reposition the hernia, sometimes surgical consultation if it's large. It's part of the workup when symptom pattern suggests it.
How long does GERD resolution take?+
Varies significantly. Patients with primarily SIBO-driven GERD often see major improvement during the SIBO treatment cycle (4-8 weeks). Patients with low stomach acid and esophageal inflammation often need 3-6 months for full resolution. Patients who've been on PPIs for many years may take longer for full gut function to restore. Most patients notice improvement within the first month.
Get Started

Resolve the Reflux. Not Just Mask It.

Book a free consultation. Dr. Dubroff will tell you what's likely driving your reflux — and what a real resolution protocol could look like.

Book Free Consultation Call 949-444-0583