MS, RD The Reflux Dietitian

You cut the coffee, the tomatoes, the citrus, the chocolate, and the wine. And your reflux is still here. Here is what I want you to know. Food is real, but for most people it is one of 5 to 7 root contributors. When we only chase the food, the actual mechanisms driving reflux stay unaddressed. These are the 5 root contributors I see most often in my practice. An under-supported lower esophageal sphincter (LES). Your LES is the muscle that keeps stomach contents where they belong. It is rarely "broken." More often it is under-supported, whether from anatomical factors like a hiatal hernia or connective tissue laxity, or from your nervous system state. One thing we practice for this is the LES Lock: 1 to 5 minutes of diaphragmatic breathing with 360 ribcage expansion immediately after meals, up to 5x daily. This strengthens the crural diaphragm that wraps around your LES. Nervous system dysregulation. Your vagus nerve is the communication line between your brain and your gut, and it helps coordinate digestion and LES tone. When your autonomic nervous system is dysregulated, that coordination gets disrupted. This is why you can eat the same meal on a calm day and a stressful day and have completely different reactions. Try the 5+1 Method before meals: 5 slow breaths plus 1 moment of gratitude to shift you into rest and digest. Motility issues. When digestion is sluggish, food and acid sit in the stomach longer, which raises the pressure pushing up against your LES. Mealtime Mindfulness helps. Chew to an applesauce consistency and slow down, since chewing drives a large share of your digestive juice production. Slow gastric emptying (gastroparesis). A more pronounced version of the same problem, where the stomach empties too slowly. The 3-hour buffer supports this. Avoid food for 3 hours before bed so your stomach can empty before you lie down. Beverages are okay. H. pylori or a microbiome imbalance (dysbiosis). Bacterial factors can shift your acid dynamics and irritate the tissue, and they are worth testing for with your provider. Autonomic dysregulation disrupting LES tone and motility is documented in the literature (Sobrino-Cossío et al., 2025, Cirugía y Cirujanos, review, PMID 40199278). Curious which root contributors are driving yours? Check the link in my bio for the free Reflux Relief Quiz. Follow for more, and share this with a friend who has cut every food and still is not better. #AcidReflux #GERD #LPR #GutHealth #VagusNerve