I read a recent NYT Well piece this week that walked through every OTC heartburn medication — antacids, H2 blockers, PPIs, alginates — and how to pick the "right one" for you.
What it never asked: why is your stomach doing this in the first place?
That's the question I want to sit with today, because if you've been cycling through Tums, then Pepcid, then a daily PPI for years and you're still burning after meals, the medication was never going to be the fix. It was only ever going to be the muffler.
Here's what's usually actually happening:
Heartburn is rarely a "too much acid" problem. More often, it's two systems struggling at once.
→ Your liver. When the liver is sluggish, often from viral burden or a diet too heavy in fat and protein, bile production weakens. Bile is essential for digestion, so when it's in short supply, your stomach compensates by overproducing HCl to pick up the slack. Over time, this exhausts the very cells that make HCl in the first place.
→ Your stomach's microbial balance. Low HCl creates the perfect environment for opportunistic bacteria, H. pylori, strep, and others, to move into the lower stomach and duodenum. These bacteria produce their own acidic byproducts that mimic HCl and irritate the esophagus. This is often what's actually burning, not your own stomach acid working correctly, but bacterial acid working against you.
→ Stress, which shifts stomach chemistry in ways that compound both of the above.
None of this shows up on a standard workup, and none of it is addressed by neutralizing acid or shutting off acid production, which is exactly why so many people stay on these medications indefinitely without ever actually healing.
Field Tools: Supporting the Terrain Naturally
Once you understand that reflux is often a bacterial and liver-load issue rather than an "acid" issue, the approach shifts from suppression to lowering the bacterial burden and supporting bile flow. Some of what I use with patients:
- Licorice root — helps address the bacteria and viral load in the intestinal tract that produce those irritating acidic byproducts
- Oregano oil, thyme tea, and elderberry syrup — support the body in naturally lowering bacterial load
- Cat's claw — used occasionally as part of rotating antimicrobial support
- Lemon balm and peppermint tea — both have antibacterial properties; peppermint in particular helps reduce bacterial presence in the upper stomach
- Olive leaf (capsule or tincture) and aloe vera — additional support for gut terrain
- Water — simple, but consistent hydration matters for flushing bacterial byproducts and supporting bile flow
This isn't a "take all of these at once" list, it's a toolkit, and the right combination depends on what's actually driving your case.
Foods That Support Healing
Alongside targeted herbal support, certain foods actively help calm the bacterial load and support the stomach and liver as they recover:
Aloe vera, apples, celery, dandelion (greens or root), ginger, kiwis, leafy greens, lemons and limes, licorice, mint, oranges and tangerines, oregano, papayas, pears, and sprouts.
Many of these work in more than one way — ginger and papaya support digestion directly, leafy greens and dandelion support the liver, and lemons and limes help balance stomach chemistry despite being acidic themselves, a detail that surprises a lot of people, since conventional advice tells you to avoid citrus entirely.
A note on medication
This doesn't mean throw out your medication tomorrow. If you have chronic reflux, difficulty swallowing, or unintended weight loss, please still see a GI doctor. Those can signal something like GERD, esophagitis, or Barrett's esophagus that needs direct medical attention. What I'm offering is the layer underneath: the root-cause work that can actually change the trajectory, done alongside, not instead of, appropriate care.
If this resonates, this is exactly the kind of case I walk through with patients: where do you look when the standard workup comes back "normal" but the person is still burning.
No Fear. You have the tools.
— Dr. Sherri
